General Discussion
In reply to the discussion: Forget about Ebola. Look what the anti-vaxxers are doing to California [View all]pnwmom
(110,318 posts)And it very quickly ended the cough in my niece who had it at age 10 (the old vaccine couldn't be given to older children and her infant vaccines had worn off).
Also, up to 90% of people will spontaneously clear pertussis even without treatment. It is deadly, however, for infants, which is why we need the vaccines.
From the CDC:
http://www.cdc.gov/mmwr/preview/mmwrhtmL/rr5414a1.htm
Maintaining high vaccination coverage rates among preschool children, adolescents, and adults and minimizing exposures of infants and persons at high risk for pertussis is the most effective way to prevent pertussis. Antibiotic treatment of pertussis and judicious use of antimicrobial agents for postexposure prophylaxis will eradicate B. pertussis from the nasopharynx of infected persons (symptomatic or asymptomatic). A macrolide administered early in the course of illness can reduce the duration and severity of symptoms and lessen the period of communicability (35). Approximately 80%--90% of patients with untreated pertussis will spontaneously clear B. pertussis from the nasopharynx within 3--4 weeks from onset of cough (36); however, untreated and unvaccinated infants can remain culture-positive for >6 weeks (37). Close asymptomatic contacts (38) (Box 3) can be administered postexposure chemoprophylaxis to prevent secondary cases; symptomatic contacts should be treated as cases.
Erythromycin, a macrolide antibiotic, has been the antimicrobial of choice for treatment or postexposure prophylaxis of pertussis. It is usually administered in 4 divided daily doses for 14 days. Although effective for treatment (Table 1) and postexposure prophylaxis (Table 2), erythromycin is accompanied by uncomfortable to distressing side effects that result in poor adherence to the treatment regimen. During the last decade, in vitro studies have demonstrated the effectiveness against B. pertussis of two other macrolide agents (azithromycin and clarithromycin) (57--64). Results from in vitro studies are not always replicated in clinical studies and practice. A literature search and review was conducted for in vivo studies and clinical trials that were conducted during 1970--2004 and used clarithromycin or azithromycin for the treatment and prophylaxis of pertussis (Table 3). On the basis of this review, guidelines were developed to broaden the spectrum of macrolide agents available for pertussis treatment and postexposure prophylaxis and are presented in this report to update previous CDC recommendations (71). Treatment and postexposure prophylaxis recommendations are made on the basis of existing scientific evidence and theoretical rationale.