Pertussis: Treatment, symptoms, advice and help
Pertussis (i.e., whooping cough) is an acute, communicable, respiratory illness causing severe, prolonged bouts of cough ending in a “whoop”.
Pertussis: Incidence, age and sex
It affects susceptible persons of all ages but is particularly serious in infants. In non-vaccinated populations, approximately 10% of reported cases occur in children younger than 1 year, 40% in children 1 to 4 years old, 45% in children 5 to 9 years old. Older than 15 years is rare in highly immunized populations nearly 40% occur in the first year of life, another 20% occur before age 5, and 25% occur in children 10 years of age or older and in adults. The clinical attack and mortality rates of pertussis are higher for females than for males.
Signs & symptoms of pertussis: Diagnosis
Classic pertussis is a lengthy illness, commonly lasting 6 to 8 weeks and characterized by three stages: catarrhal, paroxysmal, and convalescent. The catarrhal stage resembles a mild upper respiratory tract infection with coryza and cough and mild fever. The paroxysmal stage is characterized by a prolonged bout of cough followed by a single sudden massive inspiration. The characteristic whoop sound results from the forceful inhalation through a narrowed glottis. The paroxysmal episodes are exhausting. The convalescent stage is heralded by a lessening in the severity and frequency of paroxysms.
Causes and prevention of pertussis
Pertussis is caused by Bordetella pertussis and, less frequently, by Bordetella parapertussis.Both spread from patients with disease to suspectible contants through the inhalational route. Adults with protracted cough illnesses (i.e., atypical pertussis) are an important source of B.pertussia infection.Universal immunization withn the pertussis vaccine is the most important preventive measure.
Complications of pertussis are bronchopneumonia caused by secondary bacterial infections, ear infection, seizures, and apnea. The severe cough may lead to conjunctival hemorrhage, epistaxis, hernia or rectal prolapse.
The diagnosis should be suspected in any patient with prolonged cough more than 14 days without fever, hoarseness or wheeze. Isolation of B.pertussis in culture is the gold standard for diagnosis.
Antibiotics like Azithromycin help to shorten the duration and severity if started early in course of illness. Supportive treatment includes maintaining nutrition, oxygenation and hydration.