Whooping cough (pertussis)
Pertussis is an acute, vaccine‑preventable upper respiratory infection caused primarily by Bordetella pertussis (occasionally B. parapertussis). It is highly contagious and remains an important cause of severe illness and death in young infants.
Emergency department (ED) management focuses on recognising at‑risk patients (especially infants), providing supportive care, using antibiotics to limit infectivity (not to shorten established cough), and ensuring rapid notification and public‑health follow‑up.
Clinical summary
- Causative organism: Bordetella pertussis (occasionally B. parapertussis). Spread by respiratory droplets.
- Incubation: typically ~7 days (range up to 21 days).
- Infectious period: untreated, classically up to ~21 days from cough onset; with appropriate macrolide therapy, patients are usually non‑infectious 48 hours after starting treatment.
- Notifiable disease: notify local health protection team on clinical suspicion or within required local timelines (see UKHSA/GOV.UK).
Clinical features and natural history
Pertussis classically progresses through three phases; presentation may be altered by prior vaccination.
Catarrhal phase (1-2 weeks)
- Indistinguishable from a URTI - rhinorrhoea, mild cough, sore throat, conjunctivitis, malaise.
- Highest transmissibility.