Pertussis in Children

 # What Is Pertussis Or Whooping cough:

The word Pertussis is derived from Latin word 'per-intensive and tussive-cough'. Pertussis ia an acute infectious disease of young child. It is also known as 100 day cough (Chinese name) or Whooping cough.

# How is Pertussis caused:

Pertussis is caused by inhalation of Naso-pharyngeal & Bronchial secretions through Droplet infection and Droplet nuclei containing, Causative agent 'Bordetella pertusis' which infects only Man.

Bordetella pertussis

# Period of communicability:

1 week after exposure & 3 weeks after paroxysmal cough. The incubation period in Pertussis is 7-14 days. There is 90% SAR in unimmunized 

There is no subclinical or chronic carrier state. There is abscent of Maternal Antibody in child. The commonest age group is <5years but <6 months have highest mortality.

# Signs & Symptoms of Pertussis:

Bordetella Pertusis produce infection of respiratory tract epithelial tissue surface.

There is 3 stages of clinical course:

A. Acute catarrhal stage:

Most infectious stage followed by coryza, sneezing, lacrimation, mild cough lasting for 10 days.

B. Paroxysmal stage:

Paroxysmal cough, whoop sounds, tussive-cough, cyanosis lasting for 2 to 4 weeks

C. Convalescent stage:

Lasting for 1 to 2 weeks and symptoms start to decrease.

# Complications of Pertusis:

'4B' Major complications

•Bronchitis

•Bronchietasis

•Bronchopneumonia

•Bleeding:

    -Sub conjunctival haemorrhage

    -Haemoptysis

•Inguinal hernia

•Rectal bleeding

# How Pertusis is managed:

A. Laboratory diagnosis

    - Naso-pharyngeal swab culture

    - PCR

    - Immunofluorescence

    - Serological diagnosis

B. Treatments

Choice Of Drug

    - Tab Erythromycin 30-50 mg/kg

    - Vaccine DPT: active immunization

    - Hyper immunoglobin: passive immunity

# Extra on Pertussis:

∆ It shows seasonal trends & more cases in winter and spring

∆ B. Pertussis produce exo and indo  toxins

∆ No cross Immunity with Pertussis

∆ Pertussis vaccine protect 85%

∆ Catarrhal stage is most infectious

∆ Maximum complications seen in

   paroxysmal stage

∆ Pertussis involves trachea,bronchi & 

   bronchioles

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