Pertussis

Pertussis is a highly contagious bacterial disease which infects the respiratory tract and causes severe coughing fits. It is called the 100 days cough in some countries, and commonly referred to as the whooping cough, because of the “whooping” sound that the patient makes when they try to take a breath. It can affect people of any age, but it is very serious for children and particularly infants; sometimes even causing death. It affects approximately 48.5 million per year and causes almost 295 000 fatalities. It begins with mild symptoms before severe coughing fits develop, which lasts around six weeks before eventually subsiding. There are not many treatment options available, and thus immunization is the best way to fight pertussis. The A.D.A.M. Medical Encyclopaedia provides information on pertussis, including treatment, prevention, and potential complications.

Symptoms

The most common symptoms of pertussis are the respiratory whoop, a paraoxysmal cough, and vomiting after coughing. If there is vomiting after coughing, the likelihood that the patient has been infected with pertussis is nearly doubled. The cough is so violent that it can cause hernias, rib fractures, fainting and even subconjunctival hemorrhages. It begins with the incubation period, which typically lasts between 7 to 10 days. Next is the catarrhal stage, which lasts a couple of weeks and involves mild respiratory symptoms like sneezing, mild coughing, and a runny nose. These initial symptoms are extremely similar to the common cold, and can be mistakenly diagnosed as such. After a couple of weeks, the coughing changes into uncontrollable fits. Each fit consists of 5 to 10 forceful, violent coughs followed by a high-pitched “whoop”, hence the whooping cough name. Fits can be triggered by laughing, eating, yelling, yawning, or fits can occur on their own. This stage lasts somewhere between 2 to 8 weeks. This is followed by the convalescent stage, which lasts a few weeks. This stage sees the coughing decrease, both in severity and frequency, as well as a cessation of vomiting.

Prevention

Vaccination is the primary method of prevention. At this time, there is insufficient evidence to determine the effectiveness of antibiotics, though antibiotics can help make infected patients less contagious. The World Health Organization strongly recommends pertussis vaccines, and in 2002 actually saved over half a million lives with the vaccination. The vaccination does not give you complete immunity, as the duration of protection lasts for about 5 to 10 years. The pertussis infection does induce a natural immunity to patients who have recovered from it, but this is incomplete and will wane over time. The natural immunity does last longer than the vaccine immunity, however. For children, the immunizations are part of a combination of immunizations given to protect against polio, diphtheria, tetanus and haemophilus influenza type B. These are given at the ages of 15-18 months, 2, 4, and 6 years. During a pertussis outbreak, children under age 7 who are not immunized should not attend public gatherings or school. They should also be isolated from anyone who is infected for at least two weeks. If anyone in your household has a cough that lasts for over a week, seek medical attention to determine if the person has been infected with pertussis.

Treatment

If started early enough, antibiotics can be effective by helping make the symptoms go away more quickly. Most patients are diagnosed too quickly however, which makes antibiotics ineffective. Antibiotics do decrease the length of infectiousness, which is significant as it helps prevent the spread of the disease. While adults who suffer from pertussis may be able to tough it out, they can transmit the disease to people who are at a much higher risk of death or other complications. Thus, antibiotics can still be helpful. The antibiotic azithromycin or erythromycin is a popular treatment. Occasionally, a high humidity oxygen tent may be used. If the coughing fits are extremely severe, and prevent the person from drinking, fluids may be administered through an IV. Cough mixtures or syrup are not effective and should not be used.