Pertussis

Pertussis, also known as whooping cough, is a highly contagious respiratory infection (of the lungs and breathing tubes) caused by the bacterium Bordetella pertussis. In 2018, there were more than 151 000 cases of pertussis globally. There were 92,407 cases of whooping cough in England and Wales in 1957. In 2022, after the success of the vaccination programme there were 3,506. In 2022,after the success of the vaccination programme there were 3,506.

Whooping cough
Other names	Pertussis, 100-day cough
A young boy coughing due to pertussis.
Medical specialty	Infectious disease
Symptoms	Runny nose, fever, cough
Complications	Vomiting, broken ribs, exhaustion
Duration	~ 10 weeks
Causes	Bordetella pertussis (spread through the air)
Diagnostic method	Nasopharyngeal swab
Prevention	Pertussis vaccine
Treatment	Antibiotics (if started early)
Frequency	16.3 million (2015)
Deaths	58,700 (2015)

Pertussis spreads easily from person to person mainly through droplets in the breath put out by coughing or sneezing. The disease is most dangerous in infants, and is a significant cause of disease and death in this age group. The disease usually infects younger people, as they are more prone to diseases.

People with pertussis are most contagious up to about 3 weeks after the cough begins, and many children who contract the infection have coughing spells that last 4 to 8 weeks. Antibiotics are used to treat the infection. There is a vaccine that can prevent it, so most cases of it are in places where people cannot afford, cannot get, or refuse to get the vaccine. However, this vaccine does not work forever. The three-dose primary series diphtheria-tetanus-pertussis (DTP3) (- containing) vaccines lower the risk of severe pertussis in infancy. In 2018, 86% of the global target population had received the recommended three doses of DTP-containing vaccine during infancy. There is also a 6-in-1 vaccine which includes this infection for babies at 8, 12, and 16 months. WHO recommends that the first dose of the 3-in-1 vaccine is administered as early as 6 weeks of age; with the next doses given 4-8 weeks apart, at age 10-14 weeks and 14-18 weeks. A booster dose is recommended, best during the second year of life. Based on local epidemiology, further booster doses may be warranted later in life.

Vaccination of pregnant women is effective in preventing disease in infants too young to be vaccinated.

The first symptoms generally appear 7 to 10 days after infection. The disease lasts about 6 weeks (or 3 weeks after the cough begins), and symptoms include vomiting from coughing up thick mucus, and other flu-like symptoms (mild fever (high temperature is uncommon), runny nose, cough). In typical cases the cough gradually develops into a hacking cough followed by whooping (hence the common name of whooping cough). Infants may have a problem breathing and turn blue or grey. Adults commonly become red in the face. Pneumonia is a relatively common complication, and seizures and brain disease occur rarely.

Petussis can be danferous. Babies under 6 months old with whooping cough have an increased chance of having problems such as:

• dehydration
• breathing difficulties
• pneumonia
• seizures (fits)

Whooping cough is less severe in older children and adults but coughing may cause problems including:

• sore ribs
• hernia
• middle ear infections
• pee leaking out because of coughing (urinary incontinence)

A&E

Go to A&E if someone, especially a child's lips, tongue, face or skin suddenly turn blue or grey (on black or brown skin this may be easier to see on the palms of the hands or the soles of the feet), or is finding it hard to breathe properly (shallow breathing), or if someone, especially a child, has chest pain that is worse when breathing or coughing – this could be a sign of pneumonia. Also if a child is having seizures (fits).

Other websites

• Pertussis: new insights in diagnosis, incidence and clinical manifestations, F.G.A. Versteegh, Thesis, 2005