What Is Pertussis (Whooping Cough)

What Is Pertussis ?

Pertussis, which is commonly called whooping cough, is caused by a bacterium named Bordetella pertussis, This highly infectious disease is characterized by prolonged coughing fits with a  whoop, which is a high pitched sound created when the breath is drawn in with force.

  • The illness starts as a minor cold and progresses to coughing fits.
  • The characteristic whooping sound of the cough helps diagnose the disease. Testing the mucus secretions from the throat or nose can confirm the diagnosis.
  • Pertussis is an infectious disease caused by a bacterium and vaccination is effective in preventing children from contracting the disease.
  • Recovery is slow, but most of the affected children become completely cured of pertussis.
  • In severe cases, especially in infants, antibiotic treatment with hospitalization is necessary.

Pertussis used to be a very common childhood disease in most parts of the world before vaccination against this highly infectious disease became available. In developed countries like the US, it has become much less common, but complete eradication has not been possible. Every two to four years epidemics occur among people who are not vaccinated. In the developing world, whooping cough continues to affect thousands of children due to inadequate immunization measures.

Pertussis can be contracted at any age, but children are the most affected, with two third of the cases occurring in those below 18 years. The disease is very serious in infants, and babies below 2 years, as it can be fatal in about 2% cases, with the majority of deaths occurring in infants below 6 months of age. Pertussis does not provide immunity to those who have recovered from it, but if a second attack were to occur, it is often mild, and not easily recognizable as whooping cough. It may even be mistaken as a case of ‘walking pneumonia’ in adults.

When a person with whooping cough has a coughing fit, the bacteria spreads to the surrounding air through the droplets of saliva and mucus discharged from the person’s mouth. People inhaling these bacteria can become infected. After the first three weeks of illness the disease is no longer infectious even though the cough takes much longer to subside.

Symptoms

Pertussis typically has 3 stages spanning across 6 to10 weeks altogether. The initial stage has the symptoms of a mild cold such as runny nose and sneezing. The person usually has coughing at night and a feeling of illness or malaise. After a week or two, the disease progresses to its second stage which is marked by the severe coughing fits characteristic of the disease. The typical pattern is a series of five or more forceful coughs in quick succession, followed by a deep drawing of breath which produces a high-pitched sound known as the whoop. After a brief period of normal breathing, the coughing fit is repeated. Thick mucus is produced in large quantities and it may be either swallowed by children or bubble up at the nose. Children may vomit after a prolonged episode of coughing fits. Infants may have breathing problems such as extended periods without breathing, known as apnea, or choking. Their skin color may change to blue due to lack of oxygen. The final stage is that of a slow and steady recovery and it may take several weeks, or in some cases months, for the children to become completely free of the persistent cough and weakness.

Complications such as pneumonia and ear infections may develop in about a quarter of the affected children. In a few infants the brain may be affected, which may result in confusion and seizures. If brain damage occurs, it may result in permanent problems such as learning disabilities and mental retardation.

Diagnosis and Prognosis

When doctors encounter the typical whooping sound of the cough, pertussis is suspected, and a sample of the mucus from the throat or nose is cultured to confirm the disease. The test result may be accurate only in the first few weeks of the disease. If it is negative, a rapid detection test or polymerase chain reaction test may be conducted for confirmation.

Recovery from pertussis may be gradual, but eventually most children completely recover from the disease. However, children younger than 1 year carry about 2% risk of dying from whooping cough.

Prevention and Treatment

Vaccination against pertussis is routinely administered to children to protect them from the disease. Usually the combined vaccine DPT against diphtheria, tetanus and pertussis is given. When children are exposed to whooping cough, antibiotics such as erythromycin or orazithromycin may be given as a precautionary measure.

Hospitalization may be necessary if infants are severely ill with pertussis as they may need assistance with their breathing. A tube is inserted into the windpipe to provide ventilation. In less severe cases, oxygen masks may be used to provide extra oxygen. Fluids are administered intravenously. To prevent the spread of the disease, the infant is isolated till the antibiotic therapy for five days is completed. If the disease is mild, oral antibiotics are prescribed, and the child is sent home to recover. Usual cough medications are not effective against whooping cough, so they are not prescribed.

Erythromycin,  azithromycin  and clarithromycin are the antibiotics commonly used to treat pertussis. These drugs are effective against other accompanying infections such as ear infections and pneumonia too.

Watch This Educational Video About Pertussis (Whooping Cough):

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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