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Pertussis

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A baby girl receives treatment for a severe pertussis infection

Pertussis, also known as Whooping cough, is an infectious disease caused by Bordetella pertussis and Bordetella parapertussis bacterium.[1] This virus, although rather common throughout the world, is extremely contagious and can spread at epidemic rates. Those most often affected by Whooping cough are infants and adolescents who have not received complete vaccinations against pertussis. Symptoms of pertussis vary depending upon the age and situation of an individual, but the majority of people infected with pertussis experience severe coughing and shortness of breath. Although vaccines have limited the size and scope of Whooping cough in the world today, millions of people across the planet still fight against pertussis.

Symptoms

The initial symptoms of a pertussis infection appear anywhere from 6 - 21 days after the initial exposure to the virus.[2] However, detection is difficult because pertussis’ earliest symptoms are similar in many ways to those of other contagious pathogens.[3] Initial pertussis symptoms include runny nose, sneezing, and a mild fever. [4] After 10-12 days, the coughing increases in severity. As the symptoms worsen, breathing becomes more difficult. Those suffering from pertussis, especially children, make a characteristic “whooping” sound whenever they try to breath during coughing attacks. For this reason, pertussis is commonly known as Whooping cough. However, it should be noted that most adults and infants under 6 months of age do not produce the characteristic “whooping” sound associated with pertussis, thus making detection of the disease difficult.[1] Because pertussis restricts airflow through the respiratory system, vomiting, choking, dehydration, bluish skin, and apnea are all symptoms consistently associated with the Whooping cough virus.[4] In some case, pertussis can cause further complications such as seizures, convulsions, loss of consciousness,[1] pneumonia, hernias, cerebral hemorrhage, coma, or death.[5] However, these extreme instances of pertussis occur very rarely and predominantly in newborns and infants.

Transmission

This map shows the recent rise of Whooping cough in the United States.
This chart displays the Pertussis cases by age group from 1990-2011.

Pertussis is highly contagious. This virus spreads from person to person through the transfer of Bordetella pertussis and Bordetella parapertussis bacterium.[1] This bacterium exists in the fluid droplets of an infected individual’s nose and mouth. When that person coughs or sneezes they discharge the pertussis virus into the surrounding air. The bacterium then traverses into another person’s nose or mouth through inhalation, or facial contact with a surface containing the virus.[4]

Contagion lasts for approximately three weeks, but infected individuals are most contagious during the earliest stages of sickness (the first two weeks). However, an individual can shorten their period of contagion by taking antibiotics.[4]

Because Whooping cough is easily spread, and remains in the human body for so long, outbreaks are very common. Pertussis epidemics frequently occur in crowded, unsanitary areas where people have not received vaccinations for the virus. However, it should be noted that Whooping cough vaccines fade over time. As a result, vaccinations from infancy do not always protect teenagers and young adults from infection. For these two reasons, Whooping cough epidemics commonly occur on elementary and high school campuses.[3]

Treatment

Infants with Whooping cough often require hospitalization.

When people become infected with pertussis, they do not initially begin to cough. Therefore, early detection of the disease is extremely difficult. Unfortunately, antibiotics, such as erythromycin, provide little relief unless administered in the early stages of infection. For this reason, most antibiotics prescribed for pertussis patients do not combat Whooping cough, but merely prevent the spread of it.[1] These types of antibiotics are prescribed usually for a 2-week period.[4]

For children, treatment for Whooping cough can be a serious issue, often times resulting in hospitalization. In fact, 75% of infants younger than 6 months of age who suffer from pertussis will require hospital treatment.[4] While at the hospital, infants will receive constant supervision because coughing spells may prohibits their ability to breath, thereby suffocating them. However, in regards to specific treatment, it varies depending upon the issue. Patients may receive anything from IV injections and sedatives to high humidity oxygen tents. However, it should be noted that cough medicine, expectorants, and suppressants should never be used in the case of Whooping cough because they provide no relief.[1]

Prevention

Main Article: Vaccination

The most effective way to protect against pertussis is vaccination. Before vaccinations were available in the United States, approximately 5,000 – 10,000 people died annually. However, widespread vaccinations have drastically reduced this number (now averaging 30 fatalities a year).[4]

Because of children’s susceptibility to this bacterial disease, healthcare professionals recommend vaccinations beginning in early infancy. The standard shot, the DTaP vaccination, defends not only against pertussis, but also against diphtheria and tetanus.[4] This widespread immunization shot traditionally consists of five shots given in increments over 6 years beginning at 2 months, then 4 months, 6 months, 15-18 months, and then any where between 4-6 years of age. Following the DTaP injections, youths receive a Tdap vaccination around 11-12 years of age, and every 10 years following. This immunization insures an individual protection against the pertussis virus not only in their youth, but also throughout their life.[1]

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Kaneshiro, Neil K. Pertussis National Center for Biotechnology Information, U.S. National Library of Medicine . Web. Reviewed 2 August 2011.
  2. Author Unknown. Pertussis (Whooping Cough) Public Health – Seattle and King County'. Web. Updated July 16, 2012.
  3. 3.0 3.1 Author Unknown. Outbreaks Centers for Disease Control and Prevention. Web. Updated 31 October 2012.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 diPentima, Cecilia. Whooping cough (Pertussis) KidsHealth. Web. Reviewed January 2012.
  5. Bocka, Joseph J.Pertussis“Medscape Reference” Web. Updated 15 October 2012.