Pertussis – Questions

Pertussis – AKA Whooping Cough

1: what is the Causative organism in pertussis? is it gram postive or gram negative?











1A: Gram-negative bacterium Bordetella Pertussis


2: What is the Incubation period?











2A: 10 – 14 days


3. When are people immunised?













3A: Immunisation is at 2, 3, 4 months, and 3 – 5years

4. Who else is immunised? and why?












4A: Pregnant women are vaccinated as newborns are particularly vulnerable


5. How effective, long term, is the vaccination?












5A: Neither Infection or vaccination give lifelong protection – so adults may get whooping cough despite full vaccinations


6. How many cases of whooping cough are there in a year?












6A: There’s about 1000 cases reported in the UK each year


7: How does the illness usually begin?











7A: 2 -3 days of coryzal symptoms to start with


8: What happens after the initial coryzal phaze?












8A: There are coughing bouts, may result in vomiting and central cyansosis the inspiratory whoop  (caused by force inspiration against a closed glottis) is not always present


9: Where are the coughing / whooping episodes worse?











9A: Usually worse at night and after feeding


10: What can persistent coughing result in?














  • subconjunctival haemorrhage
  • occasionally anoxia leading to syncope and seizures

11: How long do symptoms last?












11A: Symptoms last 10 -14 weeks


12: In which age group is whooping cough worse in?











12A: More severe in infants

13. What’s the typical finding on the bloods?











13A: theres marked lymphocytosis

14. How can the diagnosis be confirmed?












nasal swab for Bordetella Pertussis – but this can take several days to come back

PCR and serology are now increasingly available / widespread

15: What is the treatment for pertussis?














  • Oral macrolide
    • Clarithromycin
    • Azithromycin
    • Erythromycin

16: When is this antibiotic regime helpful in a case of pertussis?












  • This is useful if the onset of the cough is within the previous 21 days

17: What does the antibiotic do in terms of the illness?











17A:  eradicates the organism and reduces the spread


18 What are four complications of whooping cough?













  • subconjunctival haemorrhage
  • pneumonia
  • bronchiectasis
  • seizures


19 What was the reason vaccination was started in pregnant women?














19A: In 2012 14 newborn infants died of whooping cough from one outbreak

The number of cases was successfully reduced with a temporary vaccination programme


20: How effective is the vaccine in preventing infection in the newborn?













20A: The vaccine is about 90% effective at preventing newborns developing int

21: What gestation women are offered the vaccine?












21A: 30 – 32 weeks pregnant .