RT Journal Article
SR Electronic
T1 Diagnosis and management of pertussis
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 509
OP 515
DO 10.1503/cmaj.1040766
VO 172
IS 4
A1 Alberto E. Tozzi
A1 Lucia Pastore Celentano
A1 Marta Luisa Ciofi degli Atti
A1 Stefania Salmaso
YR 2005
UL http://www.cmaj.ca/content/172/4/509.abstract
AB 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.