What are the indications for referring a patient with pertussis to secondary care?

Indications for referring a patient with pertussis to secondary care include:

• Significant breathing difficulties such as apnoea episodes, severe paroxysms of coughing, or cyanosis.
• Presence of significant complications like seizures or pneumonia.
• Infants aged 6 months or younger, due to their increased risk of severe illness and death, should be referred with a low threshold.
• Any patient who appears seriously unwell or has signs of respiratory distress that cannot be managed safely in primary care.
• Need for hospital admission for isolation and specialist management.

Patients meeting these criteria should be referred promptly to secondary care, and the hospital should be informed to ensure appropriate isolation measures are in place before admission.

If admission is not necessary and the cough onset is within 14 days, antibiotic treatment should be initiated in primary care.

These recommendations are based on good clinical practice and reflect the potentially serious complications of pertussis, especially in young infants.

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