pertussis: quick hits

17 Feb

(Should’ve been posted earlier, but didn’t make it up somehow.  Here it is now, though, for your learning pleasure).

Pertussis is bad and increasing – it kills ~300,000/yr in non-vaccinated places & can cause serious systemic issues like vert dissection, etc.

– B. pertussis starts like a viral URI (cough, rhinorrhea, malaise)

incubation period is about a week or so, and it is very contagious by air particles (use precautions!)

– more common in older adults who have waning immunity.

– The danger is for passing it to infants who have not immunity.

– In older adults, it is persistent cough lasting ~3-4 weeks and getting worse from week 1 to 2. Often paroxysmal.

– In infants, it is flu-like symptoms followed by paroxysmal cough with whooping inspiration against a closed glottis.

– Protect against pertussis with DTaP or Tdap.

– Test for pertussis with PCR (earlier) or culture (later)

– Treat pertussis early if possible, use Azithromycin

– Treat in those with high suspicion, those exposed, and those with suspicion with infants at home.

 

Submitted by J. Stone.

 

Sources: uptodate.com;  EMRap podcast discussion; picture

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