Pertussis (Whooping cough)

• What is whooping cough caused by?

  Gram -ve bacterium bordetella pertussis
• Is whooping cough gram -ve or +ve?

  -ve
• What bacterium is whooping cough cased by?

  Bordetella pertussis
• Who does whooping cough normally present in?

  Children
• When are infants immunised against whooping cough?

  2,3,4 months and 3-5 years
• What vaccination campaign was introduced to protect newborns?

  Immunisation for pregnant women
• Who may develop whooping cough despite being vaccinated?

  Adolescents and adults
• What are the different phases that present in whooping cough?

  Catarrhal phase

  Paroxysmal phase

  Convalescent phase
• What is the presentation of whooping cough in the catarrhal phase?

  Symptoms are similar to a viral upper respiritory tract infection.

  Lasts around 1-2 weeks
• What is the presentation of whooping cough in the paroxysmal phase?

  Cough increases in severity

  Couging is worse at night and after feeding

  Inspiritory whoop

  Infants may have apnoea

  Persistent coughing = subconjunctival haemorrhages or even anoxia

  Lasts between 2-8 weeks
• What causes the inspiratory whoop?

  Forced inspiration against a closed glottis
• What can persistent coughing cause?

  Subconjunctival haemorrhages

  Anoxia -> syncope and seizures
• What is the presentation of whooping cough in the convalescent phase?

  Subsides over weeks to months
• What is the disagnostic criteria for whooping cough?

  Acute cough lasting >14 days without another apparent cause + one or more of these features:

  • Paroxysmal cough
  • Inspiratory whoop
  • Post-tussive vomiting
  • Undiagnosed apnoetic attacks in young infants
• How is whooping cough investigated?

  Per nasal swab culture

  PCR and serology
• What is the nasal swab culture for?

  Looking for Bordetella pertussis
• How long can a nasal swab culture take to come back?

  several days or weeks
• How is whooping cough managed in infants under 6 months?

  Admitted
• Is whooping cough a notifiable disease?

  Yes
• If the onset of the cough is within the 21 day period what is given to treat whooping cough?

  Oral macrolide
• When is an oral macrolide given for whooping cough?

  If the onset is within 21 days
• Who is offered antibiotic prophylaxis for whooping cough?

  Household contacts
• What are household contacts given for whooping cough?

  Antibiotic prophylaxis
• Antibiotic therapy has not been shown to alter the course of whooping cough
• What are some complications of whooping cough?

  Subconjunctival haemorrhage

  Pneumonia

  Bronchiectasis

  Seizures
• How many weeks pregnant are women offered the whooping cough vaccine?

  16-32 weeks