Diagnosis and management of pertussis.
Pertussis is increasing in frequency among children too young to be vaccinated and among adolescents and adults. This increase is due mainly to waning immunity among vaccinated individuals, who become susceptible during adolescence and adulthood and maintain the circulation of Bordetella pertussis. Infants are at highest risk of severe illness requiring hospital admission, complications and death. The clinical presentation in adolescents, adults and vaccinated individuals may be atypical, with paroxysmal cough of short duration or simply a persistent cough. Culture and polymerase chain reaction may be used to identify B. pertussis infection, but their sensitivity is high only in the early phase of the disease. Serologic tests are not standardized for the diagnosis of pertussis, and their clinical application is limited. Erythromycin is still considered in some countries to be the "gold standard" for therapy and prophylaxis; however, azithromycin and clarithromycin seem equally efficacious and are associated with fewer side effects.
Tozzi
Alberto E
AE
Epidemiology Unit, Bambino Gesù Hospital, Rome, Italy. alberto.tozzi@opbg.net
Celentano
Lucia Pastore
LP
Ciofi degli Atti
Marta Luisa
ML
Salmaso
Stefania
S
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D004917:Erythromycin / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D010567:Pertussis Vaccine; D014917:Whooping Cough / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy
D000900:Anti-Bacterial Agents; D010567:Pertussis Vaccine; D004917:Erythromycin