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2. Respiratory diseases
– H yd ration and nutrition: ensure ch ild ren < 5 years are w ell h yd rated ; breastfeed ing
sh ould continue. A d v ise m oth ers to feed th e ch ild frequently in sm all quantities after
coug h ing bouts and th e v om iting w h ich follow s. M onitor th e w eig h t of th e ch ild
d uring th e course of th e illness, and consid er food supplem ents for sev eral w eeks
after recov ery.
–A ntibiotic th erapy: in th e first 3 w eeks after onset of coug h . Infectiv ity is2
A ntibiotic treatm ent is ind icated
v irtually nil after 5 d ays of antibiotic treatm ent.
Antibiotic Children Adults
Fisrlntie azithromycin P O 0 -5 m onth s: D 1 500 m g
once d aily, 1 0 m g / kg / d ay D 2 -D 5 2 5 0 m g / d ay
for 5 d ays ≥ 6 m onth s:
D 1 1 0 m g / kg (m ax 5 0 0 m g )
D 2 -D 5 5 m g / kg / d (m ax 2 5 0 m g / d )
erythromycin P O 5 0 m g / kg / d ay 1 g / d ay
rtveainle in 3 d iv id ed d oses, (av oid in infant < 1 m onth of ag e) 1 6 0 0 m g / d ay SM X
A for 7 d ays + 3 2 0 m g / d ay T M P
4 0 m g / kg / d ay SM X
cotrimoxazole P O + 8 m g / kg / d ay T M P
in 2 d iv id ed d oses,
for 1 4 d ays ( av oid in infant < 1 m onth of ag e,
and last m onth of preg nancy)
– F or h ospitalised ch ild ren:
• P lace th e ch ild in a sem i-reclining position (± 3 0 °).
• O ro-ph aryng eal suction if need ed .
Post-exposure prophylaxis
– A ntibiotic proph ylaxis (sam e treatm ent as for suspect cases) is recom m end ed for
unv accinated or incom pletely v accinated infants of less th an 6 m onth s, w h o h av e
h ad
contact w ith a suspect case.
– Isolation of contacts is not necessary.
Note: pertussis v accination sh ould be upd ated in all cases (suspects and contacts). If th e
prim ary series h as been interrupted , it sh ould be com pleted , rath er th an restarted from
th e beg inning .
Prevention
R outine v accination w ith polyv alent v accines containing pertussis antig ens (e.g . D T P ,
or D T P + H ep B , or D T P + H ib + H ep B ) from th e ag e of 6 w eeks or
accord ing to
national protocol.
N eith er v accination nor natural d isease confers lasting im m unity. B ooster d oses are
necessary to reinforce im m unity and red uce th e risk of d ev eloping d isease and
transm itting it to young ch ild ren.
61
– H yd ration and nutrition: ensure ch ild ren < 5 years are w ell h yd rated ; breastfeed ing
sh ould continue. A d v ise m oth ers to feed th e ch ild frequently in sm all quantities after
coug h ing bouts and th e v om iting w h ich follow s. M onitor th e w eig h t of th e ch ild
d uring th e course of th e illness, and consid er food supplem ents for sev eral w eeks
after recov ery.
–A ntibiotic th erapy: in th e first 3 w eeks after onset of coug h . Infectiv ity is2
A ntibiotic treatm ent is ind icated
v irtually nil after 5 d ays of antibiotic treatm ent.
Antibiotic Children Adults
Fisrlntie azithromycin P O 0 -5 m onth s: D 1 500 m g
once d aily, 1 0 m g / kg / d ay D 2 -D 5 2 5 0 m g / d ay
for 5 d ays ≥ 6 m onth s:
D 1 1 0 m g / kg (m ax 5 0 0 m g )
D 2 -D 5 5 m g / kg / d (m ax 2 5 0 m g / d )
erythromycin P O 5 0 m g / kg / d ay 1 g / d ay
rtveainle in 3 d iv id ed d oses, (av oid in infant < 1 m onth of ag e) 1 6 0 0 m g / d ay SM X
A for 7 d ays + 3 2 0 m g / d ay T M P
4 0 m g / kg / d ay SM X
cotrimoxazole P O + 8 m g / kg / d ay T M P
in 2 d iv id ed d oses,
for 1 4 d ays ( av oid in infant < 1 m onth of ag e,
and last m onth of preg nancy)
– F or h ospitalised ch ild ren:
• P lace th e ch ild in a sem i-reclining position (± 3 0 °).
• O ro-ph aryng eal suction if need ed .
Post-exposure prophylaxis
– A ntibiotic proph ylaxis (sam e treatm ent as for suspect cases) is recom m end ed for
unv accinated or incom pletely v accinated infants of less th an 6 m onth s, w h o h av e
h ad
contact w ith a suspect case.
– Isolation of contacts is not necessary.
Note: pertussis v accination sh ould be upd ated in all cases (suspects and contacts). If th e
prim ary series h as been interrupted , it sh ould be com pleted , rath er th an restarted from
th e beg inning .
Prevention
R outine v accination w ith polyv alent v accines containing pertussis antig ens (e.g . D T P ,
or D T P + H ep B , or D T P + H ib + H ep B ) from th e ag e of 6 w eeks or
accord ing to
national protocol.
N eith er v accination nor natural d isease confers lasting im m unity. B ooster d oses are
necessary to reinforce im m unity and red uce th e risk of d ev eloping d isease and
transm itting it to young ch ild ren.
61
