Pertussis

Pertussis

Article
Ear, Nose, & Throat (ENT)
Healthy Lungs
+3
Contributed byKrish Tangella MD, MBADec 20, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Infection due to Bordetella Pertussis
  • WC (Whooping Cough)
  • Whooping Cough (WC)

What is Pertussis? (Definition/Background Information)

  • Pertussis, also known as Whooping Cough, is a bacterial infection that affects the respiratory system and is characterized by an uncontrollable coughing that ends in a deep and long-drawn out whooping sound, while taking one’s breath.
  • This infection is extremely contagious and can severely affect very young children with permanent disabilities, even causing fatalities.
  • Immunization at a very young age, is the best form of protection against this disease.

Who gets Pertussis? (Age and Sex Distribution)

  • Pertussis may affect a newborn, young/old child, teenager, or an adult. Thus, it can be infectious at any age
  • However, prior to the use of Pertussis vaccine; children below the age of 10 years were affected the most
  • No gender or race predominance has been observed

What are the Risk Factors for Pertussis? (Predisposing Factors)

The risk factors for Pertussis include:

  • Living with or being close to, someone who has the disease, and being exposed to their respiratory droplets, while they cough or sneeze. The disease can also transmit from a mother to a child
  • Infants (less than 12 months old); especially those born preterm, with other underlying disorders
  • Any individual who has not been fully vaccinated against the infection
  • Any instance of an epidemic outbreak of Pertussis

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pertussis? (Etiology)

  • A bacterial microorganism called Bordetella pertussis (or Bordetella parapertussis), causes Pertussis. The bacteria affects the upper-respiratory tract of the body
  • In the respiratory tract, which is lined by tiny protrusions (called cilia), these bacteria release a kind of toxin. This toxin irritates, inflames, and injures the cilia, causing spontaneous and violent bursts of coughing. The airways remain partially closed too, causing the ‘gasping for breath’ whooping sound
  • Tiny droplets of respiratory fluids are released into the air, each time an affected individual coughs. These respiratory fluid droplets carry the infectious bacteria, affecting all those who come into contact with these secretions

What are the Signs and Symptoms of Pertussis?

It takes between 3-12 days for signs and symptoms to appear in an individual with Pertussis. The disease normally lasts a period of 6-7 weeks, sometimes even longer.

  • Presentations during the initial stages of the disease, when it is the most contagious, include: Nasal congestion, sneezing, mild fever, runny nose, redness of the eyes with spontaneous tearing. Many symptoms of common cold are generally observed
  • The distinct sign of a fully developed condition is the ‘whooping’ sound made following repeated bouts of coughing; this also leads to physical exhaustion. The sound is rarely observed in infants less than 6 months old, and in adults, those who have been vaccinated
  • During the final stages of the infection, the individuals may suffer chronic coughing that lasts several weeks
  • Infants below the age of 6 months may suffer from sleep apnea (which is a temporary suspension of breathing), choking, and vomiting

How is Pertussis Diagnosed?

Diagnosis of Pertussis is based on the following:

  • Physical exam with evaluation of medical history
  • Blood test; total blood count
  • Microscopic examination of nasal secretions, for presence of the bacteria
  • Tests for differential diagnosis are performed to eliminate other similar conditions

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Pertussis?

Complications of Pertussis are dependent on the age of the child/adult, and other underlying conditions that may adversely affect the individual. The complications include:

  • Bacterial pneumonia (most common complication), asthma, nose bleeds
  • Brain-related disorders; brain damage (caused by a lack of oxygen), cerebral hemorrhage, mental retardation, epileptic seizures, convulsions
  • Fractured ribs due to violent coughing
  • Dehydration due to diarrhea
  • Ear-related problems; hearing loss, infection

How is Pertussis Treated?

Early diagnosis and speedy treatment can reduce the impact of Pertussis, and help control its spread to other individuals. There is no cure for Pertussis, but managing the condition can help prevent various complications that are associated with the disease. The management measures are as follows:

  • Pertussis is generally treated with antibiotics, when detected early. Commencing treatment 3 weeks after the infection begins might prove ineffective, as the bacteria would have left the body. However, the symptoms may continue, due to the damage already inflicted
  • Use of an oxygen tent with high humidity
  • Administering fluids intravenously; when the coughing spells prevent intake of oral fluids
  • Infants may require hospitalization with close supervision, as they stand a greater risk for severe complications
  • Cough mixtures, suppressants, and expectorants are not helpful and should be avoided

How can Pertussis be Prevented?

  • Vaccinations are the best way to prevent Pertussis; infants, children, and adults (young & old) can get vaccinated
  • DTaP (Diphtheria, Tetanus, and Pertussis) vaccinations are given to infants/children. These are recommended at ages: 2 months, 4 months, 6 months, 15-18 months, and 4-6 years
  • Older children (7 years and over) and adults are prescribed Tdap vaccines, which is similar to DTaP
  • With certain health conditions, these vaccines are not recommended. Hence, do consult your healthcare provider, before administering any vaccine

What is the Prognosis of Pertussis? (Outcomes/Resolutions)

  • Pertussis infection gradually resolves over a period of 6 weeks, even though the symptoms may persist for several months
  • The prognosis is bad if complications, such as secondary bacterial pneumonia develop
  • Young infants are at the highest risk of serious complications, including death

Additional and Relevant Useful Information for Pertussis:

  • Many healthcare organizations suggest that vaccination against Pertussis could be administered beyond age of 65 years. However, this must be discussed with your physician and considered accordingly
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Krish Tangella MD, MBA picture
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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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