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?

 

 

 

 

 

 

 

 

 

 

 

 

10A:

  • 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?

 

 

 

 

 

 

 

 

 

 

14A:

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?

 

 

 

 

 

 

 

 

 

 

 

 

15A:

  • Oral macrolide
    • Clarithromycin
    • Azithromycin
    • Erythromycin

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

 

 

 

 

 

 

 

 

 

 

16A:

  • 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?

 

 

 

 

 

 

 

 

 

 

 

18A:

  • 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 .