whooping cough

Pertussis, or whooping cough, is a highly contagious respiratory illness caused by Bordetella pertussis, a fastidious gram-negative coccobacillus that is a human pathogen without known animal or environmental reservoirs. There are 8 additional known Bordetella species, 3 of which can cause respiratory illness in humans: B parapertussis (which causes infection clinically indistinguishable from pertussis), B bronchiseptica, and B holmesii.

Author/s:

Paul B. Cornia, Benjamin A. Lipsky

Routine Childhood Vaccines Given From 1 through 18 Years of Age

Brian Desmarais — Mon, 10 Aug 2020 18:25:18 +0000

Date Added:

August 10, 2020

Journal/Publication:

Mayo Clinic Proceedings

Publication Date:

August 1, 2020

Issue:

Volume:

Pages:

1780-1795

URL:

Routine Childhood Vaccines Given From 1 through 18 Years of Age

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/j.mayocp.2020.06.004

MeSH

influenza, human

Vaccine-Preventable Diseases

Meningococcal Vaccines

Haemophilus influenzae type b

measles-mumps-rubella vaccine

Diphtheria-Tetanus-acellular Pertussis Vaccines

child

An excellent review of the recommendations, rationales, and results of childhood immunizations. James W. Mold, MD, MPH

Commercial full text (fees may apply)

View

In addition to the vaccines due in the first year of life, the US Advisory Committee on Immunization Practices recommends that children continue to receive vaccines regularly against a variety of infectious diseases. Starting at 12 to 15 months of life, these include the two-dose measles-mumps-rubella vaccine series and the two-dose varicella vaccine series. Also in the second year of life, infants should begin the two-dose hepatitis A vaccine series and complete the Haemophilus influenzae type B vaccine series as well as the pneumococcal conjugate vaccine series. Before 19 months of life, infants should receive the third dose of the poliovirus vaccine and the fourth dose of diphtheria-tetanus-acellular pertussis (DTaP) vaccine. The final doses of poliovirus and tetanus-diphtheria-acellular pertussis vaccines are both due at 4 to 6 years of life. Before each influenza season, every child should receive the influenza vaccine. Those less than 9 years of age who previously received less than two doses need two doses a month apart. At 11 to 12 years of life, all should get two doses of the human papillomavirus vaccine, the adolescent/adult version of the tetanus-diphtheria-acellular pertussis vaccine, and begin a two-dose series of meningococcal ACWY vaccine. Each of these vaccines is due when the vaccine works to protect against both an immediate risk as well as to provide long-term protection. Each vaccine-preventable disease varies in terms of the nature of exposure, the form of the morbidity, the risk of mortality, and potential to prevent or ameliorate its harm.

Author/s:

Jacobson, RM

Vaccination of Adults in General Medical Practice

Brian Desmarais — Fri, 03 Jan 2020 19:37:26 +0000

Date Added:

January 3, 2020

Journal/Publication:

Mayo Clinic Proceedings

Publication Date:

January 1, 2020

Issue:

Volume:

Pages:

169–183

URL:

Vaccination of Adults in General Medical Practice

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.1016/j.mayocp.2019.02.024

Keywords

adult immunization

A review of adult immunization recommendations from Mayo. James W. Mold, MD, MPH

Free full text

View

In vaccinating adults, clinicians face 2 types of challenges: (1) staying current on recommendations for influenza, pneumococcal, hepatitis A and B, zoster, and other vaccines and (2) addressing systemic barriers to implementing practices that increase vaccination rates. Although adult immunization rates remain suboptimal, there has been much good news in adult vaccination recently. New high-dose and adjuvanted influenza vaccines help improve immune response and may reduce influenza complications in older adults. The new recombinant zoster vaccine offers significantly more efficacy against zoster outbreaks and postherpetic neuralgia than zoster vaccine live. Pertussis vaccine given during the third trimester of pregnancy may prevent between 50% and 90% of pertussis infections in infants. Shorter time for completion (1 vs 6 months) of new, adjuvanted hepatitis B vaccine may increase adherence. Clinicians can address systemic barriers to increasing vaccination rates in their clinics and health care systems by following the Centers for Disease Control and Prevention's Standards for Adult Immunization Practice. Clinicians can help increase vaccination rates by writing standing orders and by advocating for nurses or medical assistants to receive training and protected time for assessing and documenting vaccination histories and administration. Strong recommendations that presume acceptance of vaccination are effective with most patients. Communication techniques similar to motivational interviewing can help with vaccine-hesitant patients. Clinicians, as experts on providing preventive services, can educate community leaders about the benefits of immunization and can inform vaccine experts about challenges of implementing vaccination recommendations in clinical practice and strategies that can work to raise vaccination rates.

Author/s:

Hunter, P., Fryhofer, S.A., Szilagyi, P.

Routine Childhood Vaccines Given in the First 11 Months After Birth

John Bayhi — Thu, 02 Jan 2020 20:22:28 +0000

Date Added:

January 2, 2020

Journal/Publication:

Mayo Clinic Proceedings

Publisher:

Elsevier Inc.

Publication Date:

December 23, 2019

URL:

Routine Childhood Vaccines Given in the First 11 Months After Birth

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/j.mayocp.2019.06.007

Keywords

vaccines

infants

immunizations

PMID (1):

31879133

MeSH

Haemophilus influenzae type b

Influenza

Human

Rotavirus

Strepococcus pneumoniae

Poliovirus

Advisory Committees

Vaccine-Preventable Diseases

This is a nice review from Mayo of the vaccines recommended for children under the age of one including rationale, effectiveness, and concerns.

Free full text

View

The US Advisory Committee on Immunization Practices recommends that infants beginning at birth receive several vaccines directed against a variety of infectious diseases that currently pose threats of morbidity and mortality to infants and those around them, including the 3-dose hepatitis B (HepB) series. The first dose is due at birth. This series protects against maternal-infant transmission of the HepB virus and against exposure the rest of the infant's life. At age 2 months infants are to receive not only their second dose of HepB vaccine but also a series of vaccines directed against diphtheria, tetanus, pertussis, pneumococcus, rotavirus, poliovirus, and Haemophilus influenzae type b. At 4 months, infants are to repeat those vaccines except for the HepB vaccine. At age 6 months infants are to finish the HepB series and receive the third doses of the other vaccines received at 2 and 4 months except for the rotavirus vaccine, depending on the brand used. Also, starting at 6 months, depending on the time of year, infants are to begin a 2-dose series against influenza separated by 28 days. Each of these vaccines is due at a time when the vaccine works to protect against an immediate risk and to provide long-term protection. These vaccine-preventable diseases vary in terms of the nature of exposure, the form of the morbidity, the risk of mortality, and the ability of routine vaccination to prevent or ameliorate harm.

Author/s:

Jacobson, RM

Clinically Diagnosing Pertussis-associated Cough in Adults and Children: CHEST Guideline and Expert Panel Report

Tracy Ashby — Mon, 11 Feb 2019 06:00:00 +0000

Date Added:

February 11, 2019

Journal/Publication:

Chest

Publisher:

American College of Chest Physicians

URL:

Clinically Diagnosing Pertussis-associated Cough in Adults and Children: CHEST Guideline and Expert Panel Report

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/j.chest.2018.09.027

Keywords

cough

evidence-based medicine

guidelines

infectious disease

diagnosis

PMID (1):

30321509

MeSH

diagnostic tests, routine

Pertussis is relatively common these days. Protection from the vaccine is relatively short-lived. Treatment decisions must usually be made clinically prior to the results of lab test results. This guideline provides information useful for the clinical diagnosis of pertussis in both children and adults.

Commercial full text (fees may apply)

View

BACKGROUND:

The decision to treat a suspected case of pertussis with antibiotics is usually based on a clinical diagnosis rather than waiting for laboratory confirmation. The current guideline focuses on making the clinical diagnosis of pertussis-associated cough in adults and children.

METHODS:

The American College of Chest Physicians (CHEST) methodologic guidelines and the Grading of Recommendations, Assessment, Development, and Evaluation framework were used. The Expert Cough Panel based their recommendations on findings from a systematicreview that was recently published on the topic; final grading was reached by consensus according to Delphi methodology. The systematic review was carried out to answer the Key Clinical Question: In patients presenting with cough, how can we most accurately diagnose from clinical features alone those who have pertussis-associated cough as opposed to other causes of cough?

RESULTS:

In adults, after pre-specified meta-analysis exclusions, pooled estimates of sensitivity and specificity were generated for only 4 clinical features: paroxysmal cough, post-tussive vomiting, inspiratory whooping, and absence of fever. Both paroxysmal cough and absence of fever had high sensitivity (93.2% [95% CI, 83.2-97.4] and 81.8% [95% CI, 72.2-88.7], respectively) and low specificity (20.6% [95% CI, 14.7-28.1] and 18.8% [95% CI, 8.1-37.9]). Inspiratory whooping and posttussive vomiting had a low sensitivity (32.5% [95% CI, 24.5-41.6] and 29.8% [95% CI, 18.0-45.2]) but high specificity (77.7% [95% CI, 73.1-81.7] and 79.5% [95% CI, 69.4-86.9]). In children, after pre-specified meta-analysis exclusions, pooled estimates of sensitivity and specificity were generated for only 1 clinical feature in children (0-18 years): posttussive vomiting. Posttussive vomiting in children was only moderately sensitive (60.0% [95% CI, 40.3-77.0]) and specific (66.0% [95% CI, 52.5-77.3]).

CONCLUSIONS:

In adults with acute (< 3 weeks) or subacute (3-8 weeks) cough, the presence of whooping or posttussive vomiting should rule in a possible diagnosis of pertussis, whereas the lack of a paroxysmal cough or the presence of fever should rule it out. In children with acute (< 4 weeks) cough, posttussive vomiting is suggestive of pertussis but is much less helpful as a clinical diagnostic test. Guideline suggestions are made based upon these findings and conclusions.

Author/s:

Moore, Abigail, Harnden, Anthony, Grant, Cameron C., Patel, Sheena, Irwin, Richard S.

Chapter 16: Pertussis

Tracy Ashby — Fri, 07 Dec 2018 06:00:00 +0000

Date Added:

December 7, 2018

Journal/Publication:

Epidemiology and Prevention of Vaccine-Preventable Diseases, aka "Pink Book"

Publisher:

Centers for Disease Control and Prevention

Publication Date:

January 1, 2015

Pages:

261-278

URL:

Epidemiology and Prevention of Vaccine-Preventable Diseases

Type:

Meta-analyses, Reviews, and Guidelines, Meta-analyses, Reviews, and Guidelines

Keywords

MeSH

trimethoprim, sulfamethoxazole drug combination

This is a chapter on Bordetella pertussis from the Pink Book on infectious diseases. Several key points regarding pertussis in adults:

Immunization is not 100% effective but usually diminishes disease severity
In immunized adults, pertussis causes URI symptoms plus cough that can last for weeks
Antibiotics (macrolides or Bactrim) reduce contagion but have little effect on symptoms

Free full text

Pertussis, or whooping cough, is an acute infectious disease caused by the bacterium Bordetella pertussis. Outbreaks of pertussis were first described in the 16th century, and the organism was first isolated in 1906.

In the 20th century, pertussis was one of the most common childhood diseases and a major cause of childhood mortality in the United States. Before the availability of pertussis vaccine in the 1940s, more than 200,000 cases of pertussis were reported annually. Since widespread use of the vaccine began, incidence has decreased more than 80% compared with the prevaccine era.

Pertussis remains a major health problem among children in developing countries, with 195,000 deaths resulting from the disease in 2008 (World Health Organization estimate).

Author/s:

Hamborsky, Jennifer, Kroger, Andrew, Wolfe, Charles S.