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Introduction

Pertussis is a respiratory infection caused by the bacteria Bordetella Pertussis and Bordetella Parapertussis. Most cases occur in children and teens. It is common called whooping cough due to one of its characteristic features. It is a major public health issue with over 300,000 deaths annually.

Spread

The pertussis-causing bacteria is spread by inhalation of infected air droplets, which have been coughed out by an infected person. Close contact with an infected person is therefore a major risk factor for acquiring this infection. As a result it is highly contagious and a major risk to vulnerable groups like the young and immunocompromised.

Clinical Features

The first stage of whopping cough is similar to a cold and include fever, running nose and a cough.There may also be other signs of infection for example general aches and a feeling of being unwell. The cardinal symptom is a continuous stream of coughing and appears during the second stage . This can be so distressing that it ends with vomiting or impairs proper respiratory efforts resulting in cyanosis (blue discoloration due to poor gaseous exchange). The cough has a whooping sound on inspiration, due to narrowing of the airways, hence the name. The third stage is the recovery or convalescence stage as the symptoms gradually subside.

Diagnosis

The diagnosis of Pertussis is often made from the clinical presentation. However, where there is uncertainty, there are blood tests (non-specific) that can be done that may show an elevated white blood cell count, which suggests an infection. A more specific test is to swab the nose and send the specimen to be cultured; looking for the growth of the organism. There are also DNA-based tests that can be done on nasal secretions. These are quicker and more accurate but will not be widely available.

Treatment

Management is largely symptomatic and may include fluids, proper nutrition and cough medications. Household contacts should also be treated with antibiotics (erythromycin), to limit further spread. Very young patients, children with underlying medical conditions and those with severe symptoms may need to be hospitalized.

Prevention

There is a common vaccination given to young children called the DPT vaccine. This is actually a combination of vaccines for Diphtheria, Pertussis and Tetanus. A typical schedule includes three shots at 2, 4 and 6 moths followed by boosters at 1 years and 4-6 years old. Prevention also involves limiting infection to others within the household. Proper hygiene is therefore crucial.

Prognosis

Most patients recover fully from their infection. A few however, suffer from complications including lower respiratory infections, seizures and even death in a small minority.

References

http://pedi atrics.about.com/cs/commoninfe ctions/a/pertussis_3.htm

http:/ /www.medicinenet.com/pertussis /index.htm

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