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Diagnosing pertussis requires a high index of suspicion, especially given its early-stage similarity to other respiratory viral infections. The definitive diagnosis relies on a combination of clinical criteria and laboratory confirmation. Timing is critical in the diagnostic process; the sensitivity of various tests changes as the disease progresses from the catarrhal phase to the convalescent phase. At Liv Hospital, the evaluation protocol emphasizes early detection using molecular techniques to facilitate prompt isolation and treatment, thereby breaking the chain of transmission.
The clinical diagnosis is often the first step before laboratory results are available. According to global health standards, a clinical case of pertussis is typically defined as a cough illness lasting at least two weeks with one of the following classic symptoms: paroxysms of coughing, inspiratory whoop, or post-tussive vomiting. In infants, the definition is modified to include apnea as a presenting sign.
Clinicians also look for a known epidemiological link, such as contact with a person who has a confirmed case of pertussis. However, relying solely on clinical symptoms can be misleading, particularly in vaccinated individuals or adults who may present atypically.
PCR is the method of choice for diagnosing pertussis due to its high sensitivity and rapid turnaround time.
While PCR is faster, bacterial culture remains the gold standard for specific epidemiological tracking and antibiotic susceptibility testing.
Transport: The sample must be transported rapidly to the laboratory, as the bacteria do not survive long outside the body.
For patients presenting late in the course of the disease (more than 3 to 4 weeks after cough onset), PCR and culture are often negative. In these cases, serology (blood testing) is helpful.
A complete blood count (CBC) can provide a strong diagnostic clue, particularly in unvaccinated children.
Imaging is not used to diagnose the bacteria themselves, but is essential for evaluating complications.
The evaluation process must distinguish pertussis from other conditions with similar symptoms.
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The best test is usually a PCR swab of the nose and throat. It is fast and susceptible, meaning it can detect the bacteria even in small amounts.
A blood count can show a specific pattern of elevated white blood cells (lymphocytosis), which is very typical of pertussis and helps confirm the diagnosis, along with other tests.
A chest X-ray cannot detect pertussis bacteria, but it is used to check for complications such as pneumonia or collapsed lung tissue caused by severe coughing.
Swab tests often come back negative after a month because the bacteria are gone. At that point, a blood test for antibodies (serology) is the best way to check for a recent infection.
The swab needs to go deep into the back of the nose, which can be uncomfortable and cause eyes to water, but it is swift and not considered painful.
This is a worrying trend of deaths that could have been prevented by vaccines. The effect of vaccine-preventable diseases on health worldwide is huge. Knowing
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