Nursing Care Strategies in Management of Neonatal Pertussis

Background: Whooping cough, is a contagious respiratory infection caused by Bordetella pertussis. Despite widespread vaccination programs, the disease remains a global public health challenge. Neonates are most vulnerable due to immature immunity and incomplete vaccination. Clinical manifestations may include apnea, cyanosis, tachypnea, paroxysmal cough, respiratory distress, and leukocytosis. Early nursing recognition and intervention are essential to prevent complications. The aim of this review is to summarize nursing care strategies in the management of neonatal pertussis. Method: This review was conducted in ۲۰۲۵ by searching PubMed, Embase, Scopus, Web of Science, and Cochrane. The search combined keywords including "Pertussis," "Whooping cough," "Neonate," "Infant," "Nursing," and "Nurse." Eligible studies based on inclusion and exclusion criteria were analyzed, and relevant data were extracted and synthesized. Results: ۱. Early Recognition and Monitoring: Nurses should suspect pertussis in neonates with apnea, cyanosis, or paroxysmal cough. Continuous monitoring with pulse oximetry and apnea alarms is recommended. ۲. Supportive Care: Provide humidified oxygen and gentle suctioning to maintain ventilation. Prepare for assisted ventilation in severe cases and use HFNC after extubation when appropriate. Advanced interventions, including intubation, ECMO, or leukodepletion, may be required. Adequate hydration and nutrition should be ensured with IV fluids or gavage feeding when oral intake is limited. ۳. Infection Control: Apply droplet precautions (private room, mask) for at least five days after initiation of antibiotic therapy. Isolate infected neonates to prevent nosocomial transmission. ۴. Pharmacological Management: Administer macrolide antibiotics, preferably azithromycin for ۵ days (۱۰ mg/kg on day one, then ۵ mg/kg daily for four days). Start treatment immediately upon suspicion without waiting for PCR. Prophylaxis is recommended for close contacts, including family members and healthcare workers. ۵. Environmental and Safety Measures: Minimize environmental stimuli by providing a quiet and dimly lit room to reduce coughing episodes. Implement seizure precautions such as bedside safety rails due to hypoxia risk. ۶. Caregiver Education: Teach parents about cough hygiene and handwashing. Emphasize the importance of adherence to prescribed antibiotics. Educate families on immunization strategies, including maternal Tdap vaccination, to protect newborns. Conclusion: Effective management of neonatal pertussis, especially in severe cases, requires a comprehensive approach. Nursing care depends on early detection, vigilant monitoring, and supportive interventions, while strict infection control and timely antibiotic therapy help reduce complications and transmission. Caregiver education on hygiene and vaccination, with protocols emphasizing family support and interdisciplinary collaboration, can improve outcomes and lessen disease burden.

کلیدواژه ها:

Pertussis ، Nursing ، Whooping cough