Pertussis – late presentation — RACP Paediatrics MCQ

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ModerateRespiratoryPertussis – late presentationRACP Paediatrics

A 7-year-old fully vaccinated child has had 3 weeks of paroxysmal cough with whooping. Pertussis PCR is positive. The child is otherwise well. What is the most appropriate management?

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Correct answer: E — Supportive care only

In an older fully vaccinated child presenting after 3 weeks of cough, the infectious period has usually passed. Antibiotics do not alter the clinical course at this stage. Management is supportive. Azithromycin prophylaxis should be offered to close household contacts who are unvaccinated, incompletely vaccinated, or high-risk (pregnant women near term, young infants).

Reference: Australian Therapeutic Guidelines – 2024 – Antibiotic; RCH Melbourne – 2023 – Pertussis CPG