Whooping Cough Outbreak
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Respiratory medicine
Whooping Cough Outbreak
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The BBC reports today on a Scottish outbreak of Pertussis: http://www.bbc.co.uk/news/uk-scotland-19267916 We have seen a couple of cases, certainly, which is unusual. Are you seeing more whoopin
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Cat:OpenClinicalForum:8114d353-b41b-4a03-b052-dc009589d5cf
Cat:OpenClinicalForum:8114d353-b41b-4a03-b052-dc009589d5cfDiscussion:8e5be8a5-1885-4059-8eea-32a37ce6455b
Forums » Open clinical » Respiratory medicine » Whooping Cough Outbreak
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Re: Whooping Cough Outbreak
posted at 15/8/2012 6:17 PM BST
on bmj.com
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Posts: 339
First: 17/12/2011 Last: 15/5/2013 |
Yes several positive blood tests , I have not yet been able to grow from nasal swabs, meant to be nasal swabs in first 3 weeks , then blood test after 3 weeks. I think I have had 3 positives so far in adults. One of the doctors in my teaching group had adult whooping cough about ?3 months ago. About 2 weeks after the positive blood tests you get a form from public health asking if patient had erythromycin and if they had complications. I have also had one Malaria [plasmodium vivax ] ,from back packer returning from the Amazon [swimming in Amazon, tributary 2 weeks before I saw him, lucky chap], and one new pulmonary TB in last 3 weeks . Never dull in General practice. |
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Re: Whooping Cough Outbreak
posted at 15/8/2012 7:09 PM BST
on bmj.com
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Posts: 1271
First: 13/4/2010 Last: 23/5/2013 |
Yes - I think there is an upsurge. But I don't think this is unusual and it occurs every so often (I remember a similar upsurge when I did my GP training in 1992/3). It's certainly not an indication that mass immunisation is failing. |
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Re: Whooping Cough Outbreak
posted at 15/8/2012 9:13 PM BST
on bmj.com
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Posts: 20
First: 4/3/2010 Last: 2/2/2013 |
You make it sound as if its so easy to recognise the damn thing.When you have the typical whoop then it's a no brainer but the vast majority of cases are atypical and their symptoms can be indistinguishable from a viral respiratory tract infection.This can be a real headache for primary care where respiratory tract complaints are so common.Who do you test?How do you test?(testing kits are not readily available in GP surgeries),What are the cost implications for the already swamped microbiology lab? When do you treat?How effective is treatment?..alot of important unanswered questions |
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Re: Whooping Cough Outbreak
posted at 16/8/2012 3:46 AM BST
on bmj.com
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Posts: 579
First: 8/6/2011 Last: 22/5/2013 |
Sarah i agree with you. There most possible is to have an atypical whooping cough and after some days or weeks to give antibiotics . And to treat it without knowing that this was wooping cough. I remember know the saying of a new colleague of mine before years '' clarythromycin is stopping the cough'' ... |
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Re: Whooping Cough Outbreak
posted at 16/8/2012 5:23 PM BST
on bmj.com
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Posts: 12
First: 5/4/2012 Last: 19/12/2012 |
It remains vitally important that babies are vaccinated, promptly at 2 months against whooping cough. Yes, the figures are rising. See e.g. http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/WhoopingCough/EpidemiologicalData/ . The reasons are less clear. Much of the rise is in adults and adolescents - and much of this is probably due to better case ascertainment. We are also seeing a rise in babies; and much of this is probably a genuine increase. Which you would expect to see at present, as the disease has a roughly four-year epidemic cycle, and is currently peaking. There has been much debate on whether and why pertussis rates have increased. There is speculation (and some evidence) that the acellular pertussis vaccines are less effective in the longer term than the previously used (and much more reactogenic) whole cell vaccines. But don't forget - the vaccine still works very well, from quite soon after it is given; so vaccinating babies promptly reduces their chance of getting this disease; and it's babies who are most likely to be seriously ill or die if they get the disease. In the long term we need better vaccines; but we must not succumb to the "Nirvana fallacy" - the idea that if the vaccine we have isn't perfect, it must be useless. I have blogged on this subject - see http://peterenglish.blogspot.co.uk/2012/08/pertussis-vaccination-its-complicated.html |
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Re: Whooping Cough Outbreak
posted at 16/8/2012 8:50 PM BST
on bmj.com
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Posts: 20
First: 4/3/2010 Last: 2/2/2013 |
skyesteve wrote: "Hi Sarah - all GP practices in Scotland have been sent pertussis testing kits (with full instructions) together with guidance on how to recognise and manage pertussis" Hi syesteve,does this guidance inform us how to distinguish the common atypical pertussis variety from your common viral URTI?If not than it is meaningless DOH twaddle.If yes, then i'll be very interested to have a read through..perhaps you can post a link to it? Cheers Sarah |
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