Introduction of Pertussis or Whooping cough:
Whooping cough, also known as pertussis, is an infection of the respiratory system caused by the bacterium Bordetella pertussis. It is characterized by severe coughing fits that end in a "whooping" sound when the person tries to take a breath.
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| What is Pertussis or Whooping cough? |
OVERVIEW
What is Pertussis or Whooping cough?
Pertussis, also known as whooping cough, is a highly contagious bacterial infection of the respiratory system. It is caused by the bacterium Bordetella pertussis and is characterized by severe coughing fits that can last for several weeks or even months. The disease is most severe in infants and young children and can be fatal in some cases. Symptoms of pertussis include a runny nose, low-grade fever, and a mild cough that gradually becomes more severe, ending in a "whooping" sound when the person tries to take a breath. The disease is spread through the air when an infected person coughs or sneezes. Vaccination is the most effective way to prevent pertussis.
CAUSES AND RISK FACTORS
Pertussis, also known as whooping cough, is caused by the bacterium Bordetella pertussis. The disease is highly contagious and is spread through the air when an infected person coughs or sneezes.
Some of the risk factors for pertussis include:
- Lack of vaccination: People who have not been vaccinated or have not completed the full course of vaccinations are at a higher risk of contracting pertussis.
- Age: Infants and young children are at the highest risk of severe complications from pertussis, as their immune systems are not yet fully developed.
- Exposure: People who have close contact with someone who has pertussis are at a higher risk of contracting the disease.
- Weak immune system: People with weakened immune systems, such as those with HIV or AIDS, are at a higher risk of severe complications from pertussis.
- Living in crowded conditions: People living in crowded conditions, such as in group homes, boarding schools, or dormitories, are at a higher risk of contracting pertussis.
It's also worth mentioning that it's possible to get pertussis even if you've been vaccinated, but the symptoms are usually less severe than in unvaccinated people.
SIGNS AND SYMPTOMS
The signs and symptoms of pertussis, also known as whooping cough, can vary depending on the stage of the disease. The disease typically progresses through three stages:
- The catarrhal stage: This stage typically lasts for 1-2 weeks and is characterized by symptoms similar to a common cold, such as a runny nose, low-grade fever, and a mild cough.
- The paroxysmal stage: This stage typically lasts for 4-6 weeks and is characterized by severe coughing fits that can last for several minutes. The person may make a "whooping" sound when trying to take a breath after a coughing fit. This stage is the most contagious and can cause vomiting, fatigue, and sometimes even broken ribs due to intense coughing.
- The convalescent stage: This stage typically lasts for 1-2 weeks and is characterized by a gradual improvement in symptoms. The cough may persist but it becomes less severe.
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| Stages/Phases of Bordetella Pertussis |
- Bluish color around the mouth or face during a coughing fit
- Excessive fatigue after coughing
- Loss of appetite
- Runny nose
- Sneezing
- Watery eyes
It's important to note that not all people infected with pertussis will have the "whooping" sound during coughing, and it's especially rare in older children and adults. This can make the diagnosis difficult.
DIAGNOSIS
The diagnosis of pertussis, also known as whooping cough, is based on a combination of the patient's symptoms, medical history, and laboratory tests.
To diagnose pertussis, a healthcare provider will typically perform a physical examination and ask about the patient's symptoms, including the duration and severity of the cough. The healthcare provider may also ask about the patient's vaccination status and any recent contact with someone who has pertussis.
The most common diagnostic methods for pertussis are:
- Polymerase Chain Reaction (PCR): This test is done on a sample of mucus from the nose or throat, and it detects the genetic material of the Bordetella pertussis bacterium. It's considered the most accurate test for pertussis.
- Culture: This test is done on a sample of mucus from the nose or throat, and it detects the presence of the Bordetella pertussis bacterium. It's considered less sensitive than a PCR test.
- Serology: This test looks for antibodies to Bordetella pertussis in the patient's blood. It can be useful for detecting past or recent infections but it's not considered as definitive as PCR or culture.
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| Pertussis | Radiology(CXR) |
MANAGEMENT AND TREATMENT
The management and treatment of pertussis, also known as whooping cough, depends on the stage of the disease and the severity of the symptoms.
The main goals of treatment are to reduce the severity of symptoms, prevent complications, and decrease the spread of the disease to others.
Antibiotics are the main treatment for pertussis. They are most effective if given in the early stages of the disease and can shorten the duration of the illness and reduce the spread of the disease to others. The most commonly used antibiotics are macrolides such as azithromycin and clarithromycin.
In addition to antibiotics, other measures that can be used to manage pertussis include:
- Symptomatic treatment: Over-the-counter medication such as acetaminophen or ibuprofen can be used to reduce fever and relieve pain.
- Cough suppressants: These medications can be used to reduce the severity of the cough and promote rest.
- Humidifier: This can help to relieve coughing and ease breathing.
- Isolation: People with pertussis should stay at home and avoid contact with others until they have completed five days of antibiotic treatment or until 21 days after the onset of symptoms, whichever is longer.
It's also important to prevent dehydration and malnutrition by encouraging the person to drink fluids and eat nutritious food.
If the disease is severe, hospitalization may be necessary to provide supportive care such as oxygen, IV fluids, and mechanical ventilation.
It's also important to keep in mind that once infected with pertussis, immunity to the disease is not lifelong and booster shots are recommended to maintain protection.
COMPLICATIONS
Pertussis, also known as whooping cough, can cause a variety of complications, especially in infants and young children. Some of the most common complications include:
- Dehydration: Severe coughing can cause a person to lose fluids and become dehydrated.
- Pneumonia: Pertussis can lead to secondary bacterial infections, such as pneumonia.
- Apnea: Infants and young children may experience temporary pauses in breathing (apnea) during coughing fits.
- Brain damage: In rare cases, pertussis can cause brain damage due to a lack of oxygen during episodes of apnea.
- Seizures: Pertussis can also cause seizures, particularly in infants and young children.
- Loss of consciousness: Pertussis can cause loss of consciousness due to coughing and lack of oxygen.
- Sudden Infant Death Syndrome (SIDS): Pertussis has been associated with an increased risk of SIDS in infants.
- Pneumothorax: Pertussis can cause pneumothorax, which is a condition where air leaks into the space between the lung and the chest wall.
- Broken ribs: Pertussis can cause broken ribs due to intense coughing.
It's important to note that many of these complications are rare but can happen, especially in unvaccinated people or those with weak immune systems. Prompt diagnosis and treatment can help to reduce the risk of complications.
PREVENTION
The most effective way to prevent pertussis, also known as whooping cough, is through vaccination.
The pertussis vaccine is typically given as part of the diphtheria, tetanus, and pertussis (DTaP) vaccine for children and tetanus, diphtheria, and pertussis (Tdap) vaccine for adolescents and adults. The vaccine is usually given in five doses, with the first dose given at 2 months of age and the final dose given at 4-6 years of age. Boosters are recommended every 10 years for adults.
In addition to vaccination, other measures that can help to prevent pertussis include:
- Practicing good hygiene: Covering the nose and mouth when sneezing or coughing, and washing hands frequently can help to reduce the spread of the disease.
- Isolation: People with pertussis should stay at home and avoid contact with others until they have completed five days of antibiotic treatment or until 21 days after the onset of symptoms, whichever is longer.
- Vaccinating people who are in close contact with infants and young children: This includes family members, caregivers, and healthcare workers.
Pregnant women should be vaccinated during the third trimester of each pregnancy to protect their newborns before they can be fully vaccinated.
It's worth noting that even if someone is vaccinated, it's possible to get pertussis, but the symptoms are usually less severe and the risk of complications is lower.
PROGNOSIS
The prognosis of pertussis, also known as whooping cough, depends on a number of factors, including the age of the person infected, the stage of the disease at the time of diagnosis, and the presence of any underlying medical conditions.
In general, the prognosis for pertussis is good for most people, especially if the disease is diagnosed and treated early. With proper treatment, most people will recover fully within a few weeks to a couple of months.
For infants and young children, the prognosis may be more serious. They are at a higher risk of complications such as pneumonia, apnea, and brain damage, and in rare cases, pertussis can be fatal.
The recovery period for pertussis can be long, and coughing can persist for several weeks or even months. However, people usually feel better after the first 3-4 weeks and are no longer contagious 5 days after starting antibiotics.
It's important to keep in mind that once infected with pertussis, immunity to the disease is not lifelong and booster shots are recommended to maintain protection.