What is pertussis?
Pertussis, more commonly known as
whooping cough, is caused by a bacterium
(germ), Bordatella pertussis, that lives
in the mouth, nose and throat. The germ
is highly contagious and is easily
spread from person to person.
How is pertussis
spread?
The bacteria are shed in discharges from
the nose and throat and then spread to
others through coughing and sneezing. An
infected person is contagious from just
before onset of symptoms until up to
three weeks after symptoms start.
Treatment with antibiotics shortens the
contagious period to about five days.
Who can get
pertussis?
Anyone can get pertussis, it is not just
a disease that affects children.
Individuals who have not received the
pertussis vaccine or children that have
not completed vaccination for pertussis
are at risk. Additionally, while proper
vaccination against pertussis improves
immunity in children, this immunity may
decline 3-12 years after completing the
vaccination resulting in increased
susceptibility in adolescents and
adults.
What are the
symptoms of pertussis?
Symptoms usually appear 5 to 10 days
after exposure, but can take as long as
21 days. The first symptoms are similar
to those of a common cold: a runny nose,
sneezing, low-grade fever and a mild,
occasional cough. The cough gradually
becomes severe and, after one to two
weeks, the patient has spasmodic bursts
of numerous, rapid coughs. The
characteristic high-pitched "whoop"
comes from breathing in after a coughing
episode. During such an attack, the
patient may turn blue, vomit and become
exhausted. Between coughing attacks, the
patient usually appears normal. Coughing
attacks occur more frequently at night.
The attacks increase in frequency for a
couple of weeks, then remain at the same
level for two to three weeks, and then
gradually decrease. Coughing may last as
long as 10 weeks. Recovery is gradual,
and coughing episodes can recur with
subsequent respiratory infections for
months after the onset of pertussis.
Can there be complications?
Although most people recover,
complications of pertussis can be
severe. It can be a critical illness in
children younger than 1 year of age,
especially in premature babies or those
with lung disease. The most common
complication and the cause of
pertussis-related deaths is bacterial
pneumonia. Less serious complications
include ear infections, loss of appetite
and dehydration. Although infrequent,
complications affecting the brain, such
as convulsions and inflammation, may
occur, especially in infants, and can
have long-term effects or cause death.
How is pertussis
treated?
Pertussis is usually treated with the
antibiotic erythromycin. Studies have
documented that azithromycin and
clarithromycin may also be effective.
When these antibiotics can not be used
trimethoprim – sulfamethoxazole can be
used as an alternative. Some children
may need to be hospitalized. People in
close contact (regardless of age or
vaccination status) with children or
adults who have been diagnosed with
pertussis usually need to be treated
with antibiotics.
Can pertussis be
prevented?
Every child should get pertussis vaccine
at 2, 4, 6 and 15 months of age and
another dose at 4 to 6 years old. This
vaccine is given in the same shot with
diphtheria and tetanus vaccines (DTP).
Immunization is required for child care
and school attendance.
Pertussis-associated disease and death
decrease with increasing age and,
because vaccine reactions are thought to
be more frequent in older age groups,
pertussis vaccination is not normally
recommended for individuals after their
seventh birthday. All close contacts of
a person with pertussis , regardless of
age or vaccination status, should be
treated with an appropriate antibiotic
to prevent illness. |
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