Fifteen-minute consultation: a guide to pertussis.

Abstract

Pertussis (whooping cough) is a bacterial infection caused by the organism Bordetella pertussis It can lead to severe illness and death, especially in neonates and young infants. Pre-vaccination, pertussis was a major contributor to childhood morbidity and mortality. Despite global vaccination programmes, it remains a considerable public health challenge. Infants at high risk of infection presenting with cough and/or apnoea with a peripheral hyperleucocytosis due to lymphocytosis should be investigated and managed with caution. It is important for clinicians to recognise the risk of severe disease in young infants and test symptomatic patients rapidly to guide treatment decisions and inform public health response. The testing of asymptomatic persons or close contacts is not routinely recommended. Antimicrobial treatment, usually an oral macrolide, is recommended for infants, close contacts of symptomatic patients and individuals at risk of severe disease to decrease both severity and the infectious period. Preventative strategies such as immunisation programs encompassing vaccination during each pregnancy, childhood immunisation and considering lifelong additional pertussis vaccine booster doses for adults (especially when in close contact with infants and other vulnerable persons) are important patient-centred public health strategies for clinicians.