Summary about Disease
Bordetella pertussis is a highly contagious respiratory illness commonly known as whooping cough. It is caused by the bacterium Bordetella pertussis. The disease is characterized by severe coughing fits, often followed by a high-pitched "whoop" sound when the person breathes in. Whooping cough can affect people of all ages, but it is most dangerous for infants and young children.
Symptoms
Symptoms of pertussis typically develop in stages. The initial stage (catarrhal stage) resembles a common cold, with mild coughing, sneezing, and a runny nose. After 1-2 weeks, the cough becomes more severe and progresses to the paroxysmal stage, characterized by rapid, violent coughing fits (paroxysms). These fits can be followed by a high-pitched "whoop" sound as the person tries to catch their breath. Vomiting, exhaustion, and cyanosis (bluish skin due to lack of oxygen) can also occur during these fits. The convalescent stage follows, with a gradual decrease in the severity and frequency of coughing.
Causes
Whooping cough is caused by the bacterium Bordetella pertussis. The bacteria attach to the cilia (hair-like structures) lining the upper respiratory system and release toxins that damage the airways. This damage leads to inflammation and the characteristic severe coughing fits. The infection is spread through airborne droplets produced when an infected person coughs or sneezes.
Medicine Used
Antibiotics are used to treat whooping cough, especially if administered early in the illness (during the catarrhal stage). Commonly used antibiotics include azithromycin, clarithromycin, and erythromycin. Trimethoprim-sulfamethoxazole (Bactrim) may be used as an alternative. Antibiotics can reduce the severity of the illness and prevent the spread of the bacteria to others. Supportive care, such as rest, hydration, and managing cough symptoms, is also important. Infants may require hospitalization for monitoring and treatment.
Is Communicable
Yes, whooping cough is highly communicable. It is spread through airborne droplets produced when an infected person coughs or sneezes. The disease is most contagious during the catarrhal stage (early cold-like symptoms) and the first few weeks of the paroxysmal stage (severe coughing fits).
Precautions
Vaccination: The most effective way to prevent whooping cough is through vaccination with the DTaP vaccine (diphtheria, tetanus, and pertussis) for infants and children, and the Tdap vaccine (tetanus, diphtheria, and pertussis) for adolescents and adults.
Booster Shots: Pregnant women should receive a Tdap booster during each pregnancy to protect their newborn.
Hand Hygiene: Frequent handwashing with soap and water can help prevent the spread of the bacteria.
Respiratory Etiquette: Covering the mouth and nose when coughing or sneezing can reduce the spread of droplets.
Isolation: Infected individuals should stay home from school or work until they have completed a course of antibiotics and are no longer contagious, as determined by their healthcare provider.
Prophylactic Antibiotics: Close contacts of infected individuals, especially those at high risk of complications (infants, pregnant women, and people with underlying health conditions), may be given antibiotics as a preventative measure.
How long does an outbreak last?
The duration of a pertussis outbreak can vary depending on factors such as vaccination rates, population density, and public health interventions. Outbreaks can last for several months, even up to a year or longer, if not effectively controlled. Localized outbreaks tend to resolve faster than wider spread epidemics.
How is it diagnosed?
Whooping cough is diagnosed based on a combination of clinical symptoms and laboratory tests. Nasopharyngeal swabs or aspirates are collected from the back of the nose and throat to test for the presence of Bordetella pertussis bacteria using polymerase chain reaction (PCR) or culture. Blood tests may also be performed to detect antibodies to pertussis toxins, but these tests are less reliable in the early stages of the illness.
Timeline of Symptoms
Incubation Period (7-10 days, range 6-20 days): No symptoms.
Catarrhal Stage (1-2 weeks): Mild, cold-like symptoms such as runny nose, sneezing, low-grade fever, and mild cough. This stage is highly contagious.
Paroxysmal Stage (1-6 weeks, but can last up to 10 weeks or more): Severe coughing fits (paroxysms) characterized by rapid, violent coughs followed by a high-pitched "whoop" sound. Vomiting, exhaustion, and cyanosis may occur during coughing fits.
Convalescent Stage (weeks to months): Gradual decrease in the severity and frequency of coughing. The cough may persist for several months, even after the infection has cleared.
Important Considerations
Whooping cough can be particularly severe in infants and young children, leading to complications such as pneumonia, seizures, brain damage, and even death.
Adults and adolescents may have milder symptoms, but they can still transmit the infection to vulnerable individuals.
Vaccination provides the best protection against whooping cough, but immunity can wane over time, highlighting the importance of booster shots.
Early diagnosis and treatment with antibiotics are crucial to reduce the severity of the illness and prevent the spread of infection.
Reported cases of Pertussis are required to be reported to public health department to control and monitor infections.