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Pertussis
(Whooping Cough)
What is Pertussis?
Pertussis, commonly called whooping cough, is a serious contagious disease, which often requires hospitalization. It is caused by a bacterium. It most often attacks the upper respiratory tract after entering the nose or throat. Pertussis can lead to pneumonia, seizures, brain damage, and sometimes death.
Who gets Pertussis?
Persons of any age can get pertussis, however, young infants are at greatest danger of getting the disease and suffer the most serious complications. In the past, most cases occurred in children less than 5 years of age. Recently, more cases are also being reported among adolescents and adults. Pertussis most often affects persons without any pertussis vaccination, those persons with incomplete vaccinations, and those older persons who were previously immunized as children.
How is Pertussis spread?
Transmission occurs from person to person when germs pass from an infected person into the nose or throat of others. Pertussis can be transmitted by direct contact or through the air. Pertussis is highly infectious and can infect up to 70-100 percent of close household contacts who are unimmunized.
What are the symptoms of Pertussis?
Older children or adults often have no symptoms or will only have mild symptoms such as a nagging cough. These older persons still have infectious pertussis and can transmit to other unprotected persons, especially infants.
The symptoms of pertussis occur in phases. The first phase, which lasts 1-2 weeks, has cold-like symptoms with an occasional mild cough. During the second phase, which lasts 1-6 weeks, there are severe fits of coughing, a characteristic whooping sound as the person tries to gasp air between coughing, the face turns blue from coughing, and vomiting and exhaustion occur following the coughing spasms. During the third phase, which can last for several months, there is gradual reduction of the coughing spasms.
How soon do symptoms occur?
The first cold-like symptoms usually occur 5-10 days, or up to 21 days, following exposure to an infected person. During this time, few people suspect that the cold symptom or mild cough is pertussis, yet they are highly infectious to others.
How is Pertussis diagnosed?
Pertussis is usually diagnosed by a doctor based on history of symptoms, a physician examination, and supporting laboratory tests. Two common lab procedures used are culture tests using bacteria specimens taken from the nose or throat and blood tests. Laboratory tests are often necessary for pertussis because other germs can produce somewhat similar symptoms.
What is the treatment for Pertussis?
There is no cure for pertussis. Antibiotics are given to help prevent the spread of pertussis from respiratory secretions to others, and if started early enough, can also help to make the disease less severe. Antibiotics are usually taken for at least 14 days. Close contacts to pertussis cases, regardless of pertussis vaccination status, need to receive antibiotics and perhaps receive a booster dose of a pertussis containing vaccine. Patients and contacts need to be under the care of a doctor.
How long is an infected person infectious to others?
A person with pertussis can be infectious from 7 days after first being exposed to the person who transmitted it to them, up to 21 days after the severe coughing spasms begin. Persons are also infectious during the cold symptom phase of the disease before they realize they have pertussis.
Should an infected person be excluded from work or school?
Children or other persons with pertussis or their unprotected contacts should be excluded from school or other settings where people congregate for up to 14 days after exposure. They can usually return to school/work after taking physician prescribed antibiotics for 5 consecutive days.
How can Pertussis be prevented?
The best way to prevent pertussis is to ensure that children receive the recommended vaccines to prevent this disease. Persons with pertussis should be isolated from other persons. After close contact exposure to an infected person, some protection may result if 14 days of antibiotics are quickly begun. Currently licensed pertussis containing vaccines are not administered to persons after their 7th birthday.
All children and adults, should have received a primary series of 3 doses of a pertussis containing vaccine such as Diphtheria, Tetanus, and acellular Pertussis vaccine (DTaP), Diphtheria, Tetanus, and acellular Pertussis vaccine (DTP), or combinations of other vaccines which contain DTaP or DTP. The primary series is routinely given at 2, 4 and 6 months of age with a booster dose also being given at 12-18 months of age. DTaP is a preferred vaccine because fewer side effects occur. Some persons who cannot receive pertussis containing vaccine for specific medical reasons should receive a Tetanus-diphtheria (Td) or Diphtheria-tetanus (DT) vaccine, however, they will lack protection against pertussis disease.
Pertussis is known to be an under-diagnosed and under-reported communicable disease. Suspect cases need to be reported immediately to local or state health authorities for epidemiologic investigation and follow-up.
Are there any side effects to the Pertussis vaccine?
Most people have no serious reactions to this vaccine. Pertussis containing vaccines (DTaP or DTP) can cause temporary mild side effects such as a sore arm or leg, fever, fuzziness, and tiredness. This vaccine rarely causes temporary but more serious reactions such as excessive crying, very high fever, seizure, and limpness. Very rarely these vaccines can cause breathing difficulty or shock, long seizure, and coma or loss of consciousness. Generally, using DTaP vaccine will reduce the likelihood of reactions in children.
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