Whooping cough Flashcards
(13 cards)
What type of infection is whooping cough and what is it caused by?
Upper respiratory tract infection caused by Bordetella pertussis (gram negative bacteria).
Why is it called whooping cough?
Because the coughing fits are so severe that the child is unable to take any air between coughs and subsequently makes a loud whooping sound as they forcefully suck in air after the cough finishes.
Who is vaccinated against the bacteria?
Children and pregnant women are vaccinated against pertussis. The vaccine becomes less effective a few years after each dose.
When are children vaccinated against pertussis?
Part of the 6 in 1 vaccine; vaccinated at 8, 12, and 16 weeks of age; booster dose given at 3 years and 4 months.
How will the child present?
Starts with mild coryzal symptoms, low grade fever, and possibly mild dry cough. More severe coughing fits start after a week or more, described as paroxysmal cough, with a loud inspiratory whoop when the cough ends. They can cough so hard they faint, vomit, or develop a pneumothorax.
Do all patients whoop and how can infants present?
Not all patients ‘whoop’. Infants with pertussis may present with apnoeas rather than a cough.
How is a diagnosis confirmed?
Nasopharyngeal or nasal swab with PCR testing or bacterial culture can confirm the diagnosis within 2-3 weeks of the onset of symptoms. If cough > 2 weeks, patient can be tested for anti-pertussis toxin immunoglobulin G in oral fluid of children aged 5-16 and in blood of those aged over 17.
What is the diagnostic criteria for whooping cough?
should be suspected if a person has an acute cough that has lasted for 14 days or more without another apparent cause, and has one or more of the following features:
- Paroxysmal cough
- Inspiratory whoop
- Post-tussive vomiting.
- Undiagnosed apnoeic attacks in young infants
What type of disease is pertussis?
Notifiable disease.
What is the management for whooping cough?
- supportive care
- vulnerable or acutely unwell patients - those under 6 months with apnoeas, cyanosis or patients with severe coughing fits may need to be admitted
- measures to prevent spread - avoid contact with vulnerable people, dispose tissues, hand hygiene
Which antibiotics can be given?
- macrolides eg. azithromycin, erythromycin or clarithromycin - have to be excluded from school for 48 hours following the commencement of antibiotics
- beneficial in early stages (within the 1st 21 days) or vulnerable patients
- co-trimoxazole is an alternative to macrolides
Can close contacts be given anything?
Prophylactic antibiotics if they’re in a vulnerable group (e.g., pregnant women, unvaccinated infants, healthcare workers that have contact with children or pregnant women).
What is the prognosis and complications of whooping cough?
Symptoms usually resolve within 8 weeks, but can last several months. It’s known as the ‘100 day cough’ due to the potential long duration of the cough. Complication = bronchiectasis.
