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Diagnosis and management of pertussis

Alberto E Tozzi1, Lucia Pastore Celentano, Marta Luisa Ciofi degli Atti

  • 1Epidemiology Unit, Bambino Gesù Hospital, Rome, Italy. alberto.tozzi@opbg.net

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
|February 16, 2005
PubMed

Insights

Pertussis (whooping cough) is rising in all age groups due to waning immunity. Infants face the highest risk of severe pertussis illness, complications, and death.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Public Health

Background:

  • Pertussis (whooping cough) incidence is increasing globally.
  • Waning immunity in vaccinated individuals contributes to disease spread.
  • Infants are most vulnerable to severe pertussis outcomes.

Purpose of the Study:

  • To review the epidemiology and clinical presentation of pertussis.
  • To discuss diagnostic challenges and limitations.
  • To evaluate current therapeutic and prophylactic options.

Main Methods:

  • Literature review of pertussis epidemiology, diagnosis, and treatment.
  • Analysis of clinical presentations in different age groups.
  • Evaluation of diagnostic test sensitivities and specificities.

Main Results:

  • Increased pertussis frequency observed in unvaccinated children, adolescents, and adults.
  • Atypical clinical presentations are common in vaccinated individuals.
  • Diagnostic methods like culture and PCR have limited sensitivity, especially in later disease stages.
  • Serologic tests lack standardization, limiting their clinical utility.

Conclusions:

  • Pertussis resurgence necessitates improved vaccination strategies and public health awareness.
  • Early diagnosis remains challenging due to atypical presentations and diagnostic test limitations.
  • Macrolide antibiotics like azithromycin and clarithromycin offer effective treatment with fewer side effects than erythromycin.

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