Pertussis infection in adolescents and adults: Treatment and prevention
- Paul Cornia, MD
Paul Cornia, MD
- Associate Professor of Medicine
- University of Washington
- Benjamin A Lipsky, MD, FACP, FIDSA, FRCP (London), FRCPS (Glasg)
Benjamin A Lipsky, MD, FACP, FIDSA, FRCP (London), FRCPS (Glasg)
- Emeritus Professor of Medicine
- University of Washington
- Visiting Professor of Medicine
- Teaching Associate, Green Templeton College
- University of Oxford
Pertussis, also known as "whooping cough," is a highly contagious acute respiratory illness caused by Bordetella pertussis. In the pre-vaccine era, the disease predominantly affected children <10 years of age and usually manifested as a prolonged cough illness with one or more of the classical symptoms including inspiratory whoop, paroxysmal cough, and posttussive emesis .
Since the introduction of pertussis vaccines, the epidemiology of reported pertussis infections has changed; in the United States in the 1990s, more than one-half of cases occurred in adolescents and adults . Infected adolescents and adults can serve as a reservoir for infection of infants and children, who more often experience serious morbidity and mortality. Because symptoms and signs in adolescents and adults are often nonspecific, clinicians may not consider the diagnosis of pertussis.
Issues related to treatment and prevention of pertussis in adolescents and adults will be reviewed here. Issues related to treatment and prevention of pertussis in infants and children are discussed separately. (See "Pertussis infection in infants and children: Treatment and prevention".)
The pathogenesis, epidemiology, clinical manifestations, and diagnosis of this infection are discussed separately. (See "Pertussis infection: Epidemiology, microbiology, and pathogenesis" and "Pertussis infection in adolescents and adults: Clinical manifestations and diagnosis" and "Pertussis infection in infants and children: Clinical features and diagnosis".)
Based on limited data, most individuals appear to clear pertussis infection without antibiotic treatment within six weeks . Antibiotic treatment given during the early (catarrhal) phase may decrease the duration and severity of cough, but the diagnosis is rarely established during this phase among adolescents and adults. Antibiotic treatment later in the course of disease probably does not affect the course of symptoms but may be useful to reduce the spread of the infection to others.
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- Antimicrobial therapy
- Cough management
- - Tdap booster
- General use
- - Pregnant women
- Healthcare personnel
- - International strategies
- Postexposure prophylaxis
- Other control measures
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