Now, it's important to treat pertussis.
You have to treat it early and you
have to treat it appropriately
because this can progress
rapidly in young infants,
and you have to treat
suspected cases promptly.
However, the treatment's ineffective if
you start it late in the clinical course.
So, clinicians should start
to consider pertussis
in a patient with a strong clinical history.
And this will be patients
at risk for severe
or complicated disease, like infants.
So if a clinician diagnoses
the patient late,
the antibiotics aren't going to be
helpful for the patient, at this point.
It may decrease their communicability
and their ability to spread
this onto other patients,
but it's not actually going
to help that patient.
So, treatment of pertussis includes
antibiotics, typically the macrolide class,
clarithromycin, and azithromycin,
if your patients are older than 1 month old.
For newborns <1 month old,
azithromycin is the preferred agent.
Now, pertussis is a mandatory reportable
condition to the health department.
This helps the local health
department handle any outbreaks
and treat households contacts
and work contacts.
How do we treat this?
We need to administer the course
of antibiotics to the patient,
and then also to the close
contacts of the patient,
including the household contacts, sometimes,
school contacts, and sometimes, work contacts.
This needs to happen within
3 weeks of exposure
before they actually develop
their course of pertussis.
You use the same dose as
in the treatment schedule.
Patients, you want to keep them hydrated.
They need to rest.
They need supportive oxygen at some point,
and hospitalization is sometimes
necessary in the younger population.
Pertussis can cause serious and sometimes,
deadly complications in
babies and young children,
especially those who have not received all
of their recommended pertussis vaccines.
About half of the babies younger than 1 who
get pertussis need care in the hospital.
The younger the baby, the more likely they
will need to be managed in the hospital.
Unfortunately, about 1 in 4 babies, about 23%,
who are treated in the
hospital with pertussis
will develop a secondary pneumonia,
which is an infection in their lungs.
Patients can also develop ear infections.
They can have seizures.
They can lose weight, and become dehydrated.
Patients can also get injuries
from the severe coughing
and the toll it takes on their body.
Some patients will crack ribs
or develop hernias.
So, vaccines can prevent all of this.