Pertussis - Causes, Symptoms, Diagnosis, Treatment, Prevention and Complications

What Is Pertussis?

Pertussis or whooping cough is an uncontrollable, violent cough that often causes cough fits. This makes breathing difficult for the patient and requires them to take deep breaths, resulting in a “whooping” sound. It is a contagious respiratory tract infection that can affect people of all ages. It primarily affects children who have not completed their vaccination course and teenagers and adults whose immunity has faded. Though death is rare, it can cause morbidity and mortality in babies less than one year, especially in those who are not vaccinated. The best possible way to protect oneself against pertussis is through vaccination.

What Are the Causes of Pertussis?

Pertussis is an infection caused by a bacteria called Bordetella pertussis. It is transmitted from an infected person to others through the droplets from coughing or sneezing. It can also be transmitted when an uninfected person comes in contact with the surfaces touched by or the belongings of an infected person. An infected patient can be contagious for about two weeks after the beginning of the cough.

Early use of antibiotics during infection may reduce a person's infectious period. Even though they may not be aware that they have whooping cough due to minor symptoms, some people can still transmit the infection to others. Many babies who contract whooping cough are infected by parents, older siblings, or other caretakers who are unaware that they are afflicted.

What Are the Risk Factors of Pertussis?

The immunization against whooping cough one gets as a youngster ultimately wears off. Because of this, most adults and teenagers are vulnerable to the virus during an outbreak. The greatest risk of serious problems and even death is present in infants under the age of one year who have not gotten all recommended vaccinations or who have not received any vaccinations.

What Are the Symptoms of Whooping Cough?

The symptoms of pertussis usually present within five to ten days after exposure to the bacteria, but in some instances, symptoms may not show for up to three weeks. Pertussis shows symptoms similar to the common cold and may last one to two weeks. The patients usually show mild symptoms initially, which may worsen in a few people.

These symptoms can include:

• Runny nose.

• Mild fever.

• Nasal congestion.

• A mild, occasional cough.

• Watery red eyes.

• Cough fits are rapid coughs followed by a “whoop” sound.

• Vomiting due to the cough.

The symptoms may manifest differently in different age groups. Not all patients develop the “whoop.” In adolescents and adults, the primary sign may be a persistent hacking cough. In babies, the cough may be minimal or absent, and they may directly develop apnea because of the difficulty in breathing and may start turning blue because of cyanosis. This progression in babies will require emergency medical intervention.

Though the symptoms appear similar to a cold initially, they may worsen after a week or two. The extreme symptoms of “whooping cough” present because thick mucus accumulates inside the airways of the affected patients. The cough gets worse and appears more frequently at night. The symptoms may persist for ten weeks or more.

Recovery often occurs slowly, with the symptoms getting milder and less frequent.

Is It Possible to Spread Whooping Cough?

Whooping cough is extremely contagious. The bacteria are transferred from one person to another through tiny fluid droplets from an infected person's lips or nose. The incubation period, the interval between infection and the onset of symptoms, typically lasts seven to ten days but can reach 21 days.

Infected individuals are most contagious during the first two weeks of the sickness after the cough starts. The duration of contagiousness is reduced to five days following antibiotic treatment.

How Can Pertussis Be Diagnosed?

The following methods can diagnose pertussis:

• A thorough medical history is needed, noting the symptoms of the patients.

• A physical examination.

• A nose swab is then tested in the lab for the bacteria that causes pertussis.

• Blood test.

• Chest X-ray.

What Are the Treatments for Whooping Cough?

Early treatment of pertussis is the best way to manage the symptoms and help prevent the spread of the disease. Serious complications may require hospitalization. Infants may mainly require intensive care as they may present with complicated symptoms directly. Adolescents and adults can be treated at home. Antibiotics are administered for the treatment as they kill the causative bacteria and help the patients recover faster. Family members and patient attendees can be given preventive antibiotics. Over-the-counter cough medications are usually avoided as they have little or no effect on the prognosis of the disease.

How Can Pertussis Be Prevented?

The two vaccines for pertussis currently available in the United States are DTaP (diphtheria, tetanus, and acellular pertussis) and Tdap (combined tetanus, diphtheria, and acellular pertussis). The combined vaccine for diphtheria, pertussis, and tetanus is used to avoid all three infections. The vaccines are typically given to children as a series of five injections at the following ages: two months, four months, six months, 15 to 18 months, and four to six years. Booster doses are given to adults and adolescents as immunity starts to reduce by age eleven. Pregnant women should take the vaccine between 27 and 36 weeks of gestation. Infants and other people at high risk of developing severe complications of the disease should be kept away from people who have them. Sometimes, antibiotic prophylaxis is given to family members or people who can be exposed to it.

Here are some preventive measures to follow to prevent pertussis -

• Washing hands frequently with soap and water or using an alcohol-based hand rub.

• Avoid contaminating common objects or spaces after touching the face or nose to prevent transmission.

• Clean and disinfect common surfaces frequently.

• It is recommended to stay at home and avoid close contact with other people when sick.

• Getting adequate rest is the key to recovery.

• Consuming smaller meals to prevent vomiting due to cough.

• Drinking plenty of fluids to avoid dehydration.

• Staying in a smoke-free environment and avoiding smoking will help in faster recovery.

What Are the Complications Associated With Pertussis?

Complications for teens and adults seldom arise, but they occur as the side effect of strenuous coughing when they do. The associated complications are:

• Cracked ribs and associated bruising.

• Hernias in the abdominal region.

• Rupture of blood vessels in the skin or eyes.

Complications in children, however, may be more severe and may include:

• Pneumonia or fluid-filled lungs.

• Reduced or absence of breathing.

• As they may face difficulties in feeding, dehydration or weight loss might be associated.

• Damage to the brain tissues and seizures.

When Is It Appropriate to Call the Doctor?

Even if the kid has received all recommended vaccinations against pertussis, parents should still call the doctor if they suspect that the child has the illness or has been around someone who has.

This is particularly crucial if the kid coughs for extended periods and:

• The child's lips or skin turns blue, purple, or red when they cough.

• The child coughs and then vomits up.

• A whooping noise follows coughing.

• The youngster appears to experience short-term breathing cessation or difficulty breathing (apnea).

• The kid appears to be quite lethargic.

• If concerned about possible dehydration in the youngster.

• If the kid is experiencing breathing difficulties while receiving treatment at home for whooping cough, get medical attention immediately.

Conclusion:

Infants and toddlers (especially those younger than six months) are at a greater risk of complications from pertussis and are more likely to require hospitalization. If symptoms are noticed, it is best to follow preventive measures and get appropriate treatment as soon as possible. Early treatment helps prevent complications.