Postinfectious Cough: Results

Postinfectious Cough: ResultsAcellular vaccines are currently approved for children in this age group. Two adult formulations of the new acellular vaccine are now licensed in North America (2005 approval in the US) and are combined with diphtheria and tetanus toxoid (dTap). The rapid rise in the number and proportion of cases of pertussis among adolescents and adults in recent years called for a study in this age group. A large multicentered randomized, controlled, double-blind trial of acellular pertussis vaccine in a population aged 15-65 years was funded by the National Institute of Allergy and Infectious Diseases and reported in 2005. The vaccine was highly effective, with a protection rate of 92% (95% confidence interval, 32-99%), and proved to be very safe in this age group. Because the rate of pertussis in the nonimmunized population in this study was 370 cases per 100,000, the potential for case rate reduction is enormous. In 2005, the US Advisory committee on Immunization Practices endorsed the use of a single dose of dTap vaccine in adolescents aged 11-18 years. A similar recommendation has just been announced for adults up to 65 years of age. canadian health&care mall

Children and adult patients with confirmed or probable whooping cough should receive a macrolide antibiotic and should be isolated for 5 days from the start of treatment because early treatment within the first few weeks will diminish the coughing paroxysms and prevent spread of the disease; treatment beyond this period may be offered but it is unlikely the patient will respond. Level of evidence, good; net benefit, substantial; grade of evidence, A
Long-acting P-agonists, antihistamines, corticosteroids, and pertussis Ig should not be offered to patients with whooping cough because there is no evidence that they benefit these patients. Level of evidence, good; net benefit, none; grade of evidence, D
All children should receive prevention against pertussis infection as part of a complete diphtheria, tetanus, acellular pertussis (DTap) primary vaccination series. This should be followed by a single dose DTap booster vaccination early in adolescence. Level of evidence, good; net benefit, substantial; grade of evidence, A
For all adults up to the age of 65, vaccination with the stronger formulation of TDap vaccine should be administered according to CDC guidelines. Level of evidence, expert opinion; net benefit, substantial; grade of evidence, E/A

This entry was posted in Respiratory Symptoms and tagged Bordetella pertussis, pertussis infection, postinfectious cough, postviral cough.