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

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Pertussis is an extremely contagious respiratory disease also known as whooping cough, caused by the bacterium Bordetella pertussis.

Written by

Dr. Geethika. B

Medically reviewed by

Dr. N. Ashok Viswanath

Published At April 6, 2022
Reviewed AtDecember 20, 2022

What Is Pertussis?

Pertussis or whooping cough is an uncontrollable, violent cough that often causes cough fits. This makes it difficult for the patient to breathe and requires them to take deep breaths resulting in a “whooping” sound. It is an infection of the respiratory tract that is contagious and can affect people of all ages. It primarily affects children who have not completed their course of vaccination 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.

What Are the Symptoms of Whooping Cough?

Symptoms of whooping Cough

The symptoms of pertussis usually present within five to ten days after the 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 for one to two weeks. The patients usually show mild symptoms at the beginning, 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 hacking cough that is persistent. 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 that of a cold initially, the symptoms may start to worsen after a week or two. The extreme symptoms of “whooping cough” present because a 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.

How Can Pertussis Be Diagnosed?

The following methods can diagnose pertussis:

  • A thorough medical history 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 to 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.

Can Whooping Cough 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 in order 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 the immunity starts to reduce by the age of eleven. Pregnant women are recommended to 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 have the chance of being exposed to it.

How Can Pertussis Be Prevented?

Pertussis can be prevented by:

  • Washing hands frequently with soap and water or by using a hand rub that is alcohol-based.

  • To prevent transmission, avoid contaminating common objects or spaces after touching the face or nose.

  • 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, there might be associated dehydration or weight loss.

  • Damage to the brain tissues and seizures.

Conclusion:

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

Frequently Asked Questions

1.

What Is the Main Causative Factor for Pertussis?

Pertussis, also called whooping cough, is caused by a bacterium called Bordetella pertussis. This bacterium is highly contagious and transmitted from person to person through respiratory droplets when an infected person coughs or sneezes. The bacteria attach to the cilia (hair-like structures) in the respiratory tract lining, releasing toxins that damage the cilia and cause inflammation.

2.

Is There a Cure for Pertussis Infection?

While pertussis can be a serious and potentially life-threatening illness, it can be effectively treated with antibiotics and other supportive care. Antibiotics, such as azithromycin, clarithromycin, or erythromycin, are typically prescribed to treat pertussis. These antibiotics effectively kill the bacteria that cause the infection and can help reduce the duration and severity of the illness. In addition to antibiotics, supportive care such as hydration and rest can also help manage pertussis symptoms.

3.

Is Pertussis Infection Life-Threatening?

Pertussis, also known as whooping cough, can be life-threatening, particularly in infants and young children. Pertussis is caused by the bacterium Bordetella pertussis and is highly contagious. The infection affects the respiratory system and causes severe coughing fits, leading to difficulty breathing, vomiting, and exhaustion. In some cases, pertussis can lead to complications such as pneumonia, seizures, and brain damage.

4.

What Are the Diagnostic Tests for Pertussis Infection?

After a week or two, the cough becomes more severe and is characterized by rapid coughs followed by a high-pitched "whoop" sound as the person gasps for air. In addition to the characteristic cough, laboratory tests are used to confirm the diagnosis of pertussis. This may include a culture of a sample of mucus from the nose or throat or a polymerase chain reaction (PCR) test to detect the DNA of the bacteria in a sample.

5.

What Is the Best Management of Pertussis Infection?

For infants and young children at the highest risk of complications from pertussis, the most effective treatment is usually a course of antibiotics, such as azithromycin or clarithromycin, which can reduce the duration and severity of the illness. It is important to start antibiotic treatment as early as possible to prevent complications. Antibiotic treatment may still be recommended for older children and adults, particularly if the patient is at high risk of complications, such as pregnant women, people with weakened immune systems, or those with chronic respiratory conditions.

6.

Will Pertussis Become Worse at Night Time?

While coughing is the most common symptom of pertussis, the severity of the coughing fits can vary throughout the day and maybe worse at night for some individuals. Coughing fits associated with pertussis can be triggered by a variety of factors, such as exercise, eating, or even talking. In some cases, coughing fits can be more frequent and severe at night due to lying down, which can lead to postnasal drip and more frequent coughing.

7.

Is Pertussis and COVID-19 Same?

No pertussis and COVID-19 are not the same. Pertussis is caused by the bacteria Bordetella pertussis, which affects the respiratory tract and causes severe coughing. Meanwhile, Covid-19 is caused by a coronavirus and shows its effects not only in the respiratory tract but also in other systems in the body.

8.

Who Is at Risk for Pertussis Infection?

The most at-risk age group for pertussis infection are infants and young children and pregnant women especially those who have not yet completed their primary series of vaccinations. It is crucial for parents and caregivers to ensure that children receive their recommended pertussis vaccinations on schedule to protect them from this potentially life-threatening illness. Additionally, adults who come into close contact with infants and young children, such as parents, grandparents, and healthcare workers, should get vaccinated against pertussis.

9.

Can an Individual Get Pertussis Even After Getting Vaccinated?

Yes, it is possible for a person to get pertussis (also referred to as whooping cough) even after being vaccinated. While the pertussis vaccine is highly effective, it is not 100 % effective at preventing the disease. As the immunity weakens over time, incomplete vaccination and vaccination failure are reasons for a person getting pertussis even after vaccination.

10.

What Is the Final Stage of Pertussis Infection?

The final stage of pertussis infection, also known as whooping cough, is the convalescent stage. This stage typically begins around the fourth week after the onset of symptoms and can last for several weeks. During the convalescent stage, the severity of the symptoms usually begins to decrease, although coughing may persist for several weeks. The characteristic "whooping" sound may be less frequent or absent in some cases. However, coughing can still be severe and may interfere with normal activities.

11.

Will Chest X Ray Determine Pertussis?

No, a chest X-ray is not typically used to diagnose pertussis. Pertussis, also known as whooping cough, is usually diagnosed through a combination of clinical symptoms and laboratory testing.

12.

What Is the WBC Count for Pertussis Infection?

In pertussis, the WBC count may initially be normal or only slightly elevated, but may increase in the later stages of the disease. However, this is not a definitive marker of the infection, and diagnosis typically relies on clinical symptoms, history of exposure, and laboratory testing (such as a PCR test or culture for Bordetella pertussis).

13.

Will Pertussis Lead to Lung Damage?

The coughing fits in whooping cough can be so intense that they cause the airways to narrow, making it difficult to breathe. This can result in damage to the lining of the airways and the lungs themselves, and can lead to other complications such as pneumonia, bronchitis, and even collapsed lungs.
Dr. N. Ashok Viswanath
Dr. N. Ashok Viswanath

Infectious Diseases

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