What Is Whooping Cough? What Is Pertussis?Main Category: Infectious Diseases / Bacteria / Viruses
Also Included In: Respiratory / Asthma | Pediatrics / Children's Health
Article Date: 15 Mar 2013
Whooping cough, known medically as Pertussis, is an extremely contagious disease caused by the bacterium Bordetella pertussis. Whooping cough is called the 100 days' cough in some countries.
In many patients there is a distinctive hacking cough which is followed by a high-pitched gasp for air that sounds like a "whoop", hence the name.
Before the development of a vaccine, whooping cough was mainly a disease of childhood. Today, it mainly affects children who are too young to have completed the full course of vaccinations, as well as adolescents whose immunity has waned.
Before vaccines, approximately 157 people per 100,000 developed whooping cough in the USA (reported cases). There were peaks every two to five years. In 93% of cases, they were children under 10. Experts say the real incidence at that time was much higher (not all cases were reported. After the introduction of mass vaccinations in the 1940s, whooping cough rates dropped to less than 1 per 100,000 by 1970. However, since 1980 numbers have started to creep back up slightly.
In developed nations, whooping cough mortality rates are extremely low, and occur almost exclusively among infants. It is vital that pregnant mothers, as well as those who are in close contact with infants (newborns and babies up to 12 months of age), be vaccinated against pertussis.
Whooping cough affects approximately 48.5 million people every year, of whom 295,000 die. According to WHO (World Health Organization), pertussis is one of the leading causes of vaccine-preventable deaths globally. The majority of cases (over 90%) occur in low- and middle-income countries.
Children of parents who will not let them be vaccinated are 23 times more likely to develop whooping cough compared to fully immunized kids, researchers reported in the journal Pediatrics.
According to Medilexicon's medical dictionary, Pertussis is:
"An acute infectious inflammation of the larynx, trachea, and bronchi caused by Bordetella pertussis; characterized by recurrent bouts of spasmodic coughing that continues until the breath is exhausted, then ending in a noisy inspiratory stridor (the "whoop") caused by laryngeal spasm."
What are the signs and symptoms of whooping cough (pertussis)?A symptom is something the patient feels and describes to the doctor or those around him/her, while a sign is something the doctor, nurse or others can see/detect. An example of a symptom is pain, while watering eyes could be a sign.
Whooping cough symptoms usually appear between six to twenty days after the Bordetella pertussis bacterium has infected the patient, in other words, pertussis has 6-to-20 day incubation period.
The illness starts off with mild symptoms, which then get much worse before improving.
Initial signs and symptoms of pertussis are similar to those of the common cold:
Paroxysmal symptoms (more severe, suddenly intensifying symptoms)
During this second "paroxysmal stage", there are extremely intense episodes of coughing, often called "paroxysms of coughing". Symptoms include:
In very rare cases, whooping cough can cause sudden unexpected death in babies.
Whooping cough - Recovery stage
In this stage the patient starts showing signs of recovery. There are fewer bouts of coughing, which are also less intense. The recovery stage can take three or more months. Even in this stage, the patient can experience bouts of intense coughing.
What are the causes of whooping cough?As mentioned before, whooping cough is a bacterial infection caused by Bordetella pertussis. Infection occurs in the lining of the airways, principally in the trachea (the windpipe) as well as the bronchi (airways that branch off from the trachea to the lungs.
The bacterium Bordetella pertussis mainly infects the lining of the trachea and bronchi
As soon as Bordetella pertussis reaches the lining of the airways it multiplies, causing an accumulation of mucus. As the mucus builds up, the patients tries to expel it by coughing, the coughing becomes more intense because there is so much mucus.
As inflammation of the airways gets worse (they swell up), they become narrower, which makes it harder to breathe and causes the "whoop" when the patient tries to get his/her breath back after a bout of coughing.
How does whooping cough spread?People who are infected with Bordetella pertussis can transmit the infection to others from 6-20 days after the bacterium entered their body to three weeks after the start of the "whooping" cough.
The bacterium is transported in tiny droplets of water in the air. When the patient coughs and sneezes, hundreds of droplets of moisture are expelled into the air. If people nearby inhale some of it, they are exposed and could become infected.
Why are there more cases of whooping cough today?
Whooping cough in the USA - according to the CDC, the USA had the highest number of reported cases of whooping cough in 2012 since 1959. From January 1st to the end of June 2012, nearly 18,000 cases of pertussis were reported across the USA.
Washington state health authorities declared a state of emergency last year after reported cases of whooping cough rose 1,300% in one year.
How is whooping cough diagnosed?During its early stages misdiagnosis is common, because the signs and symptoms of early stage whooping cough are similar to those found in other respiratory diseases, such as bronchitis, the flu and the common cold.
A good GP (general practitioner, primary care physician), can usually diagnose whooping cough by asking questions regarding symptoms and listening to the cough (the whooping cough sound stands out).
The following diagnostic tests may be ordered:
What are the treatment options for whooping cough (pertussis)?Infants are usually admitted to hospital for treatment because for that age group pertussis is more likely to lead to complications. Intravenous infusions may be required if the child is unable to keep fluids or food down. The infant will be placed in an isolation ward to make sure the disease does not spread.
Older children, adolescents and adults can usually be treated at home.
For older children and adults symptoms are usually less severe. The doctor may advise that the patient get:
What are the complications of whooping cough (pertussis)?Older children and adults - the majority of patients recover from pertussis with no complications or problems. In most cases, complications are caused by the strain of coughing so much and so intensely, and may include:
Prevention of whooping cough (pertussis)This video is from JAMA (Journal of the American Medical Association)
The pertussis vaccine - USA
The most effective way to prevent whooping cough is by vaccinating your child. In the USA doctors usually administer a triple vaccine which protects from tetanus, diphtheria and pertussis. In the USA, the CDC recommends a series of five injections which should be given at the following ages:
Side effects may include high fever, seizures (shock or coma) and persistent crying which may last a few hours.
The 5-in-1 vaccine - UK
According to the National Health Service, in the United Kingdom the whooping cough vaccine is administered as part of the 5-in-1 vaccine (DTaP/IPV/Hib). This vaccine protects against diphtheria, tetanus, whooping cough (pertussis), polio, and Hib (Haemophilus influenzae type b).
Babies are given the 5-in1 vaccine at the following ages:
Written by Christian Nordqvist
Copyright: MediLexicon International Ltd
Original article posted on Medical News Today.
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