PERTUSSIS
(WHOOPING COUGH)
DEFINITION
●also known as whooping cough, is a highly contagious
respiratory disease. It is caused by the bacterium Bordetella
pertussis.
●Pertussis is known for uncontrollable, violent coughing
which often makes it hard to breathe.
●You may cough so hard that you vomit. The name of the
disease comes from the whooping noise you might make
when you try to breathe in after coughing.
ETIOLOGY
• Bordetella pertussis – is the cause of epidemic pertussis and the usual
cause of sporadic pertussis (image a).
• Bordetella parapertussis – is an occasional cause of sporadic pertussis
that contributes significantly to 5% of the total cause of pertussis.
(a) (b)
EPIDEMIOLOGY
• Outbreaks of pertussis were first described in the 16th century by Guillaume de
Baillou. The organism was first isolated by Jules Bordet and Octave Gengou in
1906.
• In the 20th century, pertussis was one of the most common childhood diseases and
a major cause of childhood mortality in the United States.
• Before the availability of pertussis vaccine in the 1940s, more than 200,000 cases
of pertussis were reported annually.
• Since widespread use of the vaccine began, incidence has decreased more than
75% compared with the prevaccine era.
• Pertussis remains a major health problem among children worldwide.
PATHOGENESIS
• Primarily a toxin-mediated disease
• Bacteria attach to cilia of respiratory epithelial cells
• Toxins cause inflammation which interferes with
clearance of pulmonary secretions
• Pertussis antigens allow evasion of host defenses
TRANSMISSION
• Transmission most commonly occurs person-to-person
through contact with respiratory droplets, or by contact
with airborne droplets of respiratory secretions.
Transmission occurs less frequently by contact with an
infected person’s freshly contaminated articles.
CLINICAL FEATURE
The incubation period of pertussis is commonly 7 through 10 days, with a
range of 4 through 21 days. The clinical course of the illness is divided into
three stages: catarrhal, paroxysmal, and convalescent.
• Catarrhal stage: insidious onset of coryza (runny nose), sneezing, low-
grade fever, and a mild, occasional cough similar to the common cold.
(1-2 weeks)
• Paroxysmal stage: the diagnosis of pertussis is usually suspected. More
severe cough and may experience paroxysms of numerous, rapid coughs
(1-6 weeks)
CLINICAL FEATURE
• Convalescence stage: recovery is gradual. The cough becomes less
paroxysmal and disappears in 2 to 3 weeks. However, paroxysms often
recur with subsequent respiratory infections for many months after the
onset of pertussis.
CLINICAL FEATURE
• Convalescence stage: recovery is gradual. The cough becomes less
paroxysmal and disappears in 2 to 3 weeks. However, paroxysms often
recur with subsequent respiratory infections for many months after the
onset of pertussis.
SIGNS AND SYMPTOMS
• Pertussis (whooping cough) can cause serious
illness in babies, children, teens, and adults.
Symptoms of pertussis usually develop within 5
to 10 days after you are exposed. Sometimes
pertussis symptoms do not develop for as long as
3 weeks.
SIGNS AND SYMPTOMS
EARLY SYMTOPMS Early symptoms can last for 1 to 2
weeks and usually include:
• usually starts with cold-like
symptoms and maybe a mild cough • Runny nose
or fever • Low-grade fever (generally
• In babies, the cough can be minimal minimal throughout the course of
or not even there. Babies may have a the disease)
symptom known as “apnea”. • Mild, occasional cough
Pertussis is most dangerous for • Apnea – a pause in breathing (in
babies. babies)
SIGNS AND SYMPTOMS
SIGNS AND SYMPTOMS
LATER-STAGE
SYMPTOMS
After 1 to 2 weeks and as the disease • Exhaustion (very tired) after
progresses, the traditional symptoms of coughing fits
pertussis may appear and include:
The “whoop” is often not there if you
• Paroxysms (fits) of many, rapid have milder (less serious) disease. The
coughs followed by a high-pitched infection is generally milder in teens and
“whoop” sound adults, especially those who have gotten
• Vomiting (throwing up) during or the pertussis vaccine.
after coughing fits
SIGNS AND SYMPTOMS
RECOVERY
Recovery from pertussis can happen slowly. The cough
becomes milder and less common. However, coughing fits can
return with other respiratory infections for many months after
the pertussis infection started.
SIGNS AND SYMPTOMS
RISK FACTORS
• The whooping cough vaccine you receive as a child
eventually wears off. This leaves most teenagers and adults
susceptible to the infection during an outbreak — and there
continue to be regular outbreaks.
• Infants who are younger than age 12 months who are
unvaccinated or haven't received the full set of
recommended vaccines have the highest risk for severe
complications and death.
COMPLICATIONS
Teens and adults often recover from whooping cough with no
problems. When complications occur, they tend to be side
effects of the strenuous coughing, such as:
• Bruised or cracked ribs
• Abdominal hernias
• Broken blood vessels in the skin or the whites of your
eyes
COMPLICATIONS
In infants — especially those under 6 months of age —
complications from whooping cough are more severe and
may include:
• Pneumonia
• Slowed or stopped breathing
• Dehydration or weight loss due to feeding difficulties
• Seizures
• Brain damage
DIAGNOSIS
Diagnosing whooping cough in its early stages can be difficult because
the signs and symptoms resemble those of other common respiratory
illnesses, such as a cold, the flu or bronchitis. Medical tests may be
needed to confirm the diagnosis. Such tests may include:
• A nose or throat culture and test.
• Blood tests.
• A chest X-ray.
PREVENTION
• Childhood immunization reduces the risk of catching pertussis, and
universal immunization of all infants can limit exposure by reducing
the overall number of cases.
• Booster shots may be needed throughout life to ensure that your
immunity remains intact. They are recommended for all adults 19-
65 years, and for older adults who will be in contact with babies
less than 12 months old.
• Properly wash your hands with soap and water often, especially if
you come into contact with an infected individual.
TREATMENT
• Several antibiotics are
available to treat pertussis.
The most popular are
azithromycin,
clarithromycin and
erythromycin.
LIFESTYLE AND HOME REMEDIES
• Get plenty of rest.
• Drink plenty of fluids
• Eat smaller meals
• Clean the air
• Prevent transmission.
PERTUSSIS CYCLE
