Douglas Jenkinson - The natural course of 500 consecutive cases of whooping
cough: a general practice population study
BMJ 1995:310:299-302
Setting: Discrete semirural East Midlands practice of 11500 patients.
Subjects: 500 consecutive cases of whooping cough diagnosed clinically
during 1977-92.
Conclusions: Most cases of whooping cough are relatively mild. Such cases
are difficult to diagnose without a high index of suspicion because doctors
are unlikely to hear the characteristic cough, which may be the only
symptom. Parents can be reassured that a serious outcome is unlikely. Adults
also get whooping cough, especially from their children, and get the same
symptoms as children. The difficulty of early diagnosis and probability of
missed cases reinforces the need to keep the incidence low through
immunisation in order to protect infants, who are the most vulnerable.
Key messages
In this study of 500 cases, most were mild and half the patients did not
whoop
An exclusively paroxysmal cough is the most reliable diagnostic indicator
Low frequency of such coughs means that the diagnosis may be missed without
a high index of suspicion
Herd immunity must be maintained by immunisation programmes in order to
protect those too young to be immunised
--
Tom Sargent
Bo'ness
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