PERTUSSIS

Joronny Gladys A. Lingat

Public Health Nurse IV
 CAUSES

Pertussis, a respiratory illness commonly

known as whooping cough, is a very
contagious disease caused by a type of
bacteria calledBordetella pertussis. These
bacteria attach to the cilia (tiny, hair-like
extensions) that line part of the upper
respiratory system. The bacteria release
toxins (poisons), which damage the cilia and
cause airways to swell.
 TRANSMISSION

Pertussis is a very contagious disease only found in humans.

It is spread from person to person.
People with pertussis usually spread the disease to another person by
coughing or sneezing or when spending a lot of time near one another
where you share breathing space.
Many babies who get pertussis are infected by older siblings, parents, or
caregivers who might not even know they have the disease.
Infected people are most contagious up to about 2 weeks after the
cough begins. Antibiotics may shorten the amount of time someone is
contagious.
While pertussis vaccines are the most effective tool we have to prevent
this disease, no vaccine is 100% effective.
If pertussis is circulating in the community, there is a chance that a fully
vaccinated person, of any age, can catch this very contagious disease. If
you have been vaccinated but still get sick, the infection is usually not as
bad.
EARLY SYMPTOMS
The disease usually starts with cold-like symptoms and
maybe a mild cough or fever. In babies, the cough can
be minimal or not even there. Babies may have a symptom
known as "apnea." Apnea is a pause in the child's
breathing pattern. Pertussis is most dangerous for babies.
About half of babies younger than 1 year who get the
disease need care in the hospital. Learn more about
pertussis complications.

Early symptoms can last for 1 to 2 weeks and usually

include:
Runny nose
Low-grade fever (generally minimal throughout the
course of the disease)
Mild, occasional cough
Apnea a pause in breathing (in babies)

Because pertussis in its early stages appears to be nothing

more than the common cold, it is often not suspected or
diagnosed until the more severe symptoms appear.
LATER STAGE SYMPTOMS

after 1 to 2 weeks and as the disease progresses, the traditional

symptoms of pertussis may appear and include:

Paroxysms (fits) of many, rapid coughs followed by a high-

pitched "whoop"
Vomiting (throwing up) during or after coughing fits
Exhaustion (very tired) after coughing fits

Pertussis can cause violent and rapid coughing, over and over,
until the air is gone from the lungs and you are forced to inhale
with a loud "whooping" sound. This extreme coughing can
cause you to throw up and be very tired. Although you are often
exhausted after a coughing fit, you usually appear fairly well in-
between. Coughing fits generally become more common and
bad as the illness continues, and can occur more often at
night. The coughing fits can go on for up to 10 weeks or more.
In China, pertussis is known as the "100 day cough." However,
the "whoop" is often not there for people who have milder (less
serious) disease. The infection is generally milder in teens and
adults, especially those who have been vaccinated.
DISEASE PROGRESSION
 COMPLICATIONS

BABIES AND CHILDREN:

Pertussis (whooping cough) can cause serious and sometimes deadly
complications in babies and young children, especially those who are
not fully vaccinated.
In babies younger than 1 year old who get pertussis, about half need
care in the hospital. The younger the baby, the more likely treatment
in the hospital will be needed. Of those babies who are treated in the
hospital with pertussis about:
1 out of 4 (23%) get pneumonia (lung infection)
1 out of 100 (1.1%) will have convulsions (violent, uncontrolled
shaking)
3 out of 5 (61%) will have apnea (slowed or stopped breathing)
1 out of 300 (0.3%) will have encephalopathy (disease of the brain)
1 out of 100 (1%) will die
 COMPLICATIONS

TEENS AND ADULTS

can also get complications from pertussis. They are usually less
serious in this older age group, especially in those who have been
vaccinated with a pertussis vaccine. Complications in teens and
adults are often caused by the cough itself. For example, you may
pass out or break (fracture) a rib during violent coughing fits.
In one study, less than 1 out of 20 (5%) teens and adults with
pertussis needed care in the hospital. Pneumonia (lung infection)
was diagnosed in 1 out of 50 (2%) of those patients. The most
common complications in another study were:
Weight loss in 1 out of 3 (33%) adults
Loss of bladder control in 1 out of 3 (28%) adults
Passing out in 3 out of 50 (6%) adults
Rib fractures from severe coughing in 1 out of 25 (4%) adults
 DIAGNOSIS

Pertussis (whooping cough) can be diagnosed

by taking into consideration if you have been
exposed to pertussis and by doing a:
History of typicalsigns and symptoms
Physical examination
Laboratory testwhich involves taking a sample
of mucus (with a swab or syringe filled with
saline) from the back of the throat through the
nose Blood test
PREVENTION
Vaccines
The best way to prevent pertussis (whooping cough) among
babies, children, teens, and adults is to get vaccinated. Also, keep
babies and other people at high risk for pertussis complications
away from infected people.

Infection
If your doctor confirms that you have pertussis, your body will
have a natural defense (immunity) to future infections. Some
observational studies suggest that pertussis infection can provide
immunity for 4 to 20 years. Since this immunity fades and does
not offer lifelong protection, vaccination is still recommended.
 ANTIBIOTICS

If you or a member of your household has been diagnosed with

pertussis, your doctor or local health department may recommend
preventive antibiotics (medications that can help prevent diseases
caused by bacteria) to other members of the household to help
prevent the spread of disease. Additionally, some other people outside
the household who have been exposed to a person with pertussis may
be given preventive antibiotics, including
People at risk for serious disease
People who have routine contact with someone that is considered at
high risk of serious disease
Babies younger than 1 year old are most at risk for serious
complications from pertussis. Although pregnant women are not at
increased risk for serious disease, those in their third trimester
would be considered at increased risk since they could in turn
expose their newborn to pertussis. You should discuss whether or
not you need preventative antibiotics with your doctor, especially if
there is a baby or pregnant woman in your household or you plan to
 HYGIENE

Like many respiratory illnesses, pertussis is spread by coughing and

sneezing while in close contact with others, who then breathe in the
pertussis bacteria. Practicing good hygiene is always recommended
to prevent the spread of respiratory illnesses.
To practice good hygiene you should:
Cover your mouth and nose with a tissue when you cough or
sneeze.
Put your used tissue in the waste basket.
Cough or sneeze into your upper sleeve or elbow, not your hands,
if you don't have a tissue.
Wash your hands often with soap and water for at least 20
seconds.
Use an alcohol-based hand rub if soap and water are not available.