PERTUSSIS IN PRIMARY CARE PRACTICE : Recent Advances in Diagnosis, Treatment, and Prevention - 11/09/11

Doi : 10.1016/S0095-4543(05)70362-6

Linda Waggoner-Fountain, MD ^{^{*
From the Department of Pediatrics, Children's Medical Center of the University of Virginia, Charlottesville, Virginia}}, Gregory F. Hayden, MD ^{^{*
From the Department of Pediatrics, Children's Medical Center of the University of Virginia, Charlottesville, Virginia}}

Résumé

Pertussis long has been recognized as a serious threat to children's health in the developing world. Despite remarkable advances in global childhood immunization rates during the past 2 decades, it is estimated that more than 350,000 infants and children still die of pertussis each year in developing countries.^{17 Edwards K.M., Decker M.D., Graham B.S. , et al. Adult immunization with acellular pertussis vaccine JAMA 1993 ; 269 : 53-56

Cliquez ici pour aller à la section Références, 26 Hewlett E.L. Selective primary health care: Strategies for control of disease in the developing world. XVIII. Pertussis and diphtheria Rev Infect Dis 1985 ; 7 : 426-435

Cliquez ici pour aller à la section Références} What perhaps is not so well known is that pertussis remains a disease of considerable public health importance in this country. Many of the other vaccine-preventable diseases have been well controlled in the United States by widespread immunization, but pertussis remains problematic. Primary care practitioners who thought that whooping cough was disappearing after the fashion of smallpox and polio may have been surprised by the multiple outbreaks of pertussis throughout the United States in 1993.^{1 Pertussis outbreak American Academy of Pediatric News 1993 ; 9 : 2

Cliquez ici pour aller à la section Références, 6 Bass J.W., Wittler R.R. Return of epidemic pertussis in the United States Pediatr Infect Dis J 1994 ; 13 : 343-345

Cliquez ici pour aller à la section Références, 7 Centers for Disease Control and Prevention Pertussis Surveillance MMWR 1993 ; 42 : 642

Cliquez ici pour aller à la section Références, 10 Christie C.D.C., Marx M.L., Marchant C.D. , et al. The 1993 epidemic of pertussis in Cincinnati: Resurgence of disease in a highly immunized population of children N Engl J Med 1994 ; 331 : 16-21 [cross-ref]

Cliquez ici pour aller à la section Références} During 1994, more than 1600 infants younger than 1 year of age were diagnosed with pertussis, making pertussis the most common vaccine-preventable illness in children in this age group.^{41 Summary of Reportable Notifiable Disease 1994 MMWR 1995 ; 43 : 10

Cliquez ici pour aller à la section Références}

This recent rise in the number of cases of pertussis has heightened interest in its diagnosis, treatment, and prevention. First, there has been greater demand for a diagnostic test that is rapid and reliable. The increasing awareness of atypical illnesses among young infants and adolescents has made laboratory confirmation particularly important. Once the diagnosis of pertussis has been established, the primary focus of attention shifts to treatment options, especially the role of antimicrobial therapy for patients and their close contacts. Finally, the development of acellular vaccines for use in pertussis prevention has stimulated renewed discussions as to whom, how, and when to vaccinate.^{17 Edwards K.M., Decker M.D., Graham B.S. , et al. Adult immunization with acellular pertussis vaccine JAMA 1993 ; 269 : 53-56

Cliquez ici pour aller à la section Références} When can we begin to immunize infants with these newer vaccines? Should we consider reimmunization of adolescents and adults as well? This article reviews the clinical presentation of pertussis infection, new laboratory tests available to aid in diagnosis, new recommendations for treatment, and recent developments in pertussis vaccines.

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Plan

CAUSE AND PATHOGENESIS

Address reprint requests to Linda Waggoner-Fountain, MD, Department of Pediatrics, Box 386, University of Virginia Health Sciences Center, Charlottesville, VA 22908