A vaccine preventable disease

Identification and Definition

Pertussis is most commonly known as whooping cough. Whooping cough often resembles a cold, but progresses to a serious and highly contagious respiratory tract infection. Vaccination is recommended for all ages, with emphasis on childhood vaccination between 6 months and 6 years of age.

History of Pertussis

Between 1940 and 1945, more than 1 million cases of whooping cough were reported, creating a common cause of morbidity and mortality. After the vaccine was created in the 1940s, cases of the disease steadily declined until the 1980s. At this time cases of pertussis slowly began to increase again.

  • In 2008, 195,000 pertussis related deaths were reported in developing countries.
  • In 2014, there were 32,971 total documents cases or pertussis (a 15% increase from 2013)
Pertussis is currently considered a disease of concern.

Signs and Symptoms of Pertussis

The first stage of whooping cough, the catarrhal stage, lasts about 1-2 weeks.

  • symptoms resemble the common cold
  • low grade fever
  • mild cough.

The second stage is what usually identifies pertussis.

  • The patient has bursts of rapid coughs (paroxysm).
  • The end of each burst resulting in a high pitched whoop.
  • During each attack, the patient looks very ill, and may appear blue (especially infants)

Transmission of Pertussis

B. Pertussis is a bacterial pathogen that is highly communicable and found only to transmit from human to human. Transmission of whooping cough most commonly occurs through contact with airborne respiratory droplets or respiratory secretions. Transmission is less common, but possible, by contact with contaminated items of an infected person.

Complications of Pertussis

Infants are at a higher risk for complications than children and adolescents. Data shows that the most common complication, secondary bacterial pneumonia, results in 5.2% of all reported cases, but in 11.8% of infants (classified as under 6 months of age). Other complications are related to lack of oxygen supply, causing neurological problems. The neurological complications include seizures and encephalopathy

Other complications in children include:

  • Dehydration
  • Pneumothorax
  • Hernias
Other complications in adults include:

  • Rib fracture
  • Difficulty sleeping
  • Urinary incontenance

Recommended Control Measures for Pertussis

The best way to prevent whooping cough is through vaccination. There are two current vaccinations available: the DTap and Tdap.

  • The DTap is the childhood vaccination recommended for ages 6 months to years old.
  • The Tdap is the adolescent and adult vaccination.
  • Both of these vaccinations protect against pertussis, diphtheria, and tetanus.
  • The DTap is given in 4 doses in 4-8 week intervals. The last recommended dose is recommended for 15-18 months.
  • Adolescents and adults that have received the childhood vaccine are recommended to get the Tdap as well to prevent infection and reduce likelihood of transmission

The current acellular vaccines range from about 80-85% effective. Because there is still a concerning amount of deaths in developing countries due to pertussis (see history), and 32,971 documented cases of pertussis in 2014, vaccination is strongly recommended.

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