Whooping cough (pertusis)

Whooping cough (pertusis)

• 1.
  Whooping cough (pertusis) introduction Whooping cough(pertusis) is a contagious disease. It is characterized by cough that sounds like ‘whoop’, hence the name, whooping cough. The sound occurs due to strained vocal cords. It is a life-threatening infection in the infants (less than 1 year).  Pertussis (whooping cough) is a respiratory tract infection characterized by a paroxysmal cough. The most common causative organism is Bordetella pertussis though Bordetella parapertussis has also been associated with this condition in humans.
• 2.
  Causative agents  Whoopingcough is caused by the bacteria Bordetella pertussis and Bordetella parapertussis. Which are Gram –ve bacteria.  These bacteria invade the cilia lining the upper respiratory tract and release toxins that impair the function of cilia.
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  Mode of Transmission Itspreads from one person to another through:  Respiratory droplets(coughing,sneezing,saliva etc)  Airborne transmission  Close contact
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  Clinical features Whooping coughcan be divided into three stages based on the progression of the disease. • Catarrhal Stage: It is the early stage that may last for 1 to 2 weeks. The bacteria inflame the mucus membrane. At this stage, the patients are highly contagious. • Paroxysmal Stage: The disease is intensified and the patients become severely ill in this stage. This stage may last from 2 to 6 weeks. • Convalescent Stage: It is the recovery phase and patients are no longer contagious. This stage may last from several weeks to months.
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  contd. Symptoms may developdepending upon the stage of the disease. Stage 1 – Catarrhal phase • Nasal congestion • Rhinorrhea • Sneezing • Low-grade fever • Tearing • Conjunctival suffusion Stage 2 – Paroxysmal phase • Paroxysms of intense coughing lasting up to several minutes, occasionally followed by a loud whoop • Posttussive vomiting and turning red with coughing Stage 3 – Convalescent stage • Chronic cough, which may last for weeks if pt develops secondary infection symptoms may return.
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  Signs persistant cough, apnea,whoop cough, exhaustion, coryza, paroxysms, runny nose,postussive vomiting,underlying signs..
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  Incubation period • Theincubation period of pertusis is commonly 7 to 10 days with a range of 4 to 21 days . • Rarely may be as long as 42 days Risk factors • People living in poor environmental hygiene, bad sanitation, and crowded places are susceptible to infection. Other high-risk population includes: • Infants < 6 months of age (because of undeveloped immune system) • Premature infants • Adolescents and young adults whose vaccine has worn off (vaccine wears off after a certain amount of time, generally 10 years) • Children who did not undergo vaccination • People who are in close contact with infected person • Pregnant women
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  Early diagnosis • Diagnosisof whooping cough is made based on patient’s signs and symptoms, medical history, and other diagnostic tests such as X-ray, blood tests and culture of nasopharyngeal secretions. • Complete Blood Count (CBC): Blood sample is collected for examination. Lymphocyte (white blood cells) levels and erythrocyte sedimentation rate (ESR) are usually elevated in this condition. • Chest X-ray: It is an imaging test that helps to detect inflammation in the lungs. • Enzyme Linked Immunosorbent Assay (ELISA): This test helps to identify antibodies such as IgG, IgM, and IgA in the serum or plasma. • Culture Test: Two samples are taken from each nostril at the posterior nasopharynx with a swab. Then the swabs are examined for bacteria through gram staining technique
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  Treatment • The infectedpatient should be isolated first and people caring for the infected patients should wear protective equipment to prevent spread of infection. Treatment options for whooping cough include: • Supplemental oxygen, nasopharyngeal suction (removing of phlegm by inserting a catheter through nose), and intravenous (IV) fluids are provided if the child’s condition is severe and is hospitalized. • Antibiotics such as azithromycin, erythromycin, and clarithromycin are commonly recommended to treat the infection.
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  Prevention and controlmeasure • Vaccination is the best measure to prevent whooping cough. DTaP is the vaccine available for whooping cough. This vaccine provides protection against diphtheria, tetanus, and pertussis. • Dosage schedule of vaccine for babies, according to Centers for Disease Control and Prevention (CDC): • First dose: 2 months old • Second dose: 4 months • Third dose: 6 months • Booster doses: 15 and 18 months • Maintenance doses: 4 and 6 year Take medications as per prescription. Don’t stop medications, unless advised by your doctor. • Take plenty of rest. • Consume diet rich in nutrition. • Stay hydrated. Drink clean, purified water. • To prevent spread of infection, cover your mouth while coughing or sneezing. You can also wear a mask to cover your mouth
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  complications • Bronchitis isthe common complication of whooping cough. Other complications that may occur are: • Pneumonia • Hemoptysis (coughing up blood) • Cerebral hemorrhage and seizures (due to brain damage) • Epistaxis (bleeding from the nose) • Weight loss