Diagnosing and Treating Pertussis
Even if someone has all of the signs and symptoms of pertussis, your doctor will likely order a laboratory test to confirm it. Once a diagnosis is made or suspected exposure has been determined, antibiotic therapy should be started. This will reduce the spread of infection and the severity of illness, though the length of the illness will not change once coughing paroxysms have already started.
What to Expect
It is rare for a diagnosis to be made before a patient has reached the coughing paroxysm phase, since pertussis can initially mimic the common cold. Adolescents and adults can take even longer to get diagnosed, as sometimes the only symptom they have is a prolonged cough.
Treatment is available and can help reduce the complications seen in younger infants. However, if it is not started early, it may not change the clinical course, especially in school-age children, adolescents, and adults.
How Is Pertussis Diagnosed?
A test from secretions in the back of the nose or throat (culture or PCR) are most commonly used to diagnose pertussis. The specimens are collected from either a small tube passed deep into the nose or a special swab. Results will come back within a day of the PCR test, but longer with the culture. Cultures are less useful in adolescents and adults as they can have symptoms for several weeks before pertussis is even suspected. Patients with more than 4 weeks of cough may only be diagnosed with a special blood test.
How Is Pertussis Treated?
Pertussis is generally treated with antibiotics; it is very important that treatment is started early to reduce severity and duration of the illness, as well as reduce the likelihood of spreading the infection to others. Treatment after 3 weeks of illness is unlikely to help, because the bacteria are typically gone from your body, despite still having symptoms. The symptoms are persistent because the bacteria have already done damage to your body.
There are several antibiotics available to treat pertussis. The recommended drugs are azithromycin, clarithromycin and erythromycin.
Pertussis can sometimes be very serious, requiring treatment in the hospital. Infants have the greatest risk of severe complications from pertussis.
The use of cough medications is not recommended in the treatment of pertussis cough and will probably not help.
This content was developed in partnership with the CHEST Foundation, the philanthropic arm of the American College of Chest Physicians.