Sunday, 22 May 2016

Pertussis (whooping cough) immunisation information

Public Health England has updated its information for public health professionals relating to pertussis (whooping cough).

Whooping cough     is a highly infectious disease that is usually caused by Bordetella pertussis. A similar illness is caused by B. parapertussis, but this is not preventable with presently available vaccines.

There is an initial catarrhal stage, followed by an irritating cough that gradually becomes paroxysmal, usually within one to two weeks. The paroxysms are often followed by a characteristic ‘whoop’ or by vomiting. In young infants, the typical ‘whoop’ may never develop and coughing spasms may be followed by periods of apnoea. The illness often lasts for two to three months. In older children and adults, the disease may present as persistent cough without these classic symptoms and therefore not be recognised as whooping cough.

Pertussis may be complicated by bronchopneumonia, repeated vomiting leading to weight loss, and cerebral hypoxia with a resulting risk of brain damage. Severe complications and deaths occur most commonly in infants under six months of age. Minor complications include subconjunctival haemorrhages, epistaxis (nosebleeds), facial oedema, ulceration of the tongue or surrounding area, and suppurative otitis media.

Transmission of the infection is by respiratory droplet, and cases are most infectious during the early catarrhal phase. The incubation period is between six and 20 days and cases are infectious from six days after exposure to three weeks after the onset of typical paroxysms.

The update takes the form of a revision to the ‘Green Book’ and it can be accessed here.

Posted by Dr. Tim Sandle

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