Pertussis

Diagnostic criteria

Non-drug treatment

Drug treatment

A communicable respiratory infection usually recognized by a paroxysmal cough followed by an inspiratory whoop and associated vomiting. Subconjunctival haemorrhages may be present. The cough can persist for 3months or longer with the infectious period between 2 weeks and 3 months. The disease is more severe in young infants where it may present with apnoea rather than the inspiratory whoop. Incubation period: 7–10 days. Range: 6– 21 days. 

Diagnostic criteria 

• Diagnosis is clinical 
• A definitive diagnosis often not possible with respect to viral pertussis-like syndrome 
• FBC usually very high WCC with > 50% lymphocytosis 
• Use naso-pharyngeal aspirates if possible for cultures for Bordetella Pertussis 

Non-drug treatment 

• Isolation during first 2 days whilst on antibiotic therapy 
• Clear airways by gentle suction taking care not to induce cough 
• Appropriate respiratory support for apnoea or respiratory distress/failure 
• If hypoxic, give oxygen, 1–2 l/minute via nasal prongs 
• Encourage oral feeding. If unsuccessful provide nasogastric feeds with small volumes. 
• Immunise infant against pertussis even if diagnosis of pertussis was made 

Drug treatment 

• Erythromycin oral, 10–15 mg/kg/dose, 6 hourly for 14 days 
  • All contacts of presumed pertussis, including adults. 
  • Children: Erythromycin oral, 10–15 mg/kg/dose, 6 hourly for 14 days 
  • Adults: Erythromycin oral, 250 mg , 6 hourly for 14 days 
  • Vaccinate contacts where appropriate. 
• Notify