Pertussis

CDC Clinical Case Definition:  Cough >2 weeks in duration, with either:
  • A “Whoop” (very rare beyond early childhood); OR
  • Coughing Paroxysms; OR
  • Post-Tussive Vomiting
Consider if <2 wks of Sx: — Pts in contact with babies <6-months-old.  Teach parents/guardians of such babies to:
  • seek care for them at first sign of URI (catarrhal phase)
  • explain possible pertussis contact to baby’s provider.
Laboratory Diagnosis important for epidemiological reasons.  If Dx 2 cases close in time:
  • contact Health Dept. to obtain kit for nasopharyngeal swab

BEWARE — don’t over-identify “paroxysms” as an excuse to Rx azithromycin.

Catch 22
  • Treatment shortens symptoms & prevents transmission if begun within 2 wks
  • BUT case definition says “cough >2 wks duration”
  • (However:  Tx might ↓ transmission if given up to 3-4 wks)

See posting Acute Cough – 1 (end of post).

Advertisements