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Whooping cough

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VOL: 100, ISSUE: 43, PAGE NO: 31

- Whooping cough or pertussis is an infectious bacterial disease caused by Bordetella pertussis….

 

WHAT IS WHOOPING COUGH?

 

- Whooping cough or pertussis is an infectious bacterial disease caused by Bordetella pertussis.

 

 

- The disease is characterised by bouts of paroxysmal coughing.

 

 

- The cough can last for many weeks and in some cases can persist for up to three months.

 

 

- Whooping cough is contagious.

 

 

- Immunisation against the disease means it is now uncommon in the UK.

 

 

- Pertussis can have serious complications particularly in babies who are less than six months old. It can be fatal.

 

 

HOW IS IT SPREAD?

 

- Pertussis is spread by infected droplets.

 

 

- The incubation period is 7-10 days after contact with an infected person.

 

 

- The infectious period lasts from one to three weeks after the onset of bouts of coughing.

 

 

- Five days of antibiotic treatment ensures a case is non-infectious.

 

 

INCIDENCE

 

- Most cases occur in children, but adults can be infected especially if they have not been immunised.

 

 

- Before the immunisation programme was introduced in the 1950s there was an average of 100,000 notified cases each year in England and Wales.

 

 

- In the early 1970s immunisation coverage of more than 80 per cent reduced incidence to a few thousand cases each year.

 

 

- Immunisation levels dropped in the late 1970s and early 1980s because of public anxiety about a possible link between the vaccine and brain damage.

 

 

- Immunisation coverage levels are now up to 94 per cent and the number of notified cases in England and Wales in 2003 was only 409.

 

 

SYMPTOMS

 

- Presents initially like a common cold with a fever.

 

 

- After a few days an irritating cough develops into persistent coughing bouts, which can be distressing and exhausting.

 

 

- The characteristic ‘whoop’ of the cough is the sound of the sucking in of air after prolonged coughing out.

 

 

- The ‘whoop’ is not always present, particularly in infants.

 

 

- Coughing may be followed by vomiting.

 

 

- The number of coughing bouts per day is 12-20 on average, but can be as many as 100.

 

 

- Babies may go blue during or immediately after a bout of coughing.

 

 

- If in doubt, diagnosis can be made by a throat or nose swab to confirm the presence of B. pertussis.

 

 

WHAT ARE THE COMPLICATIONS?

 

- Pertussis is usually most severe in infants, about half of whom are admitted to hospital. Oxygen therapy and rehydration may be needed.

 

 

- Pneumonia can develop as a secondary lung infection. Look out for high temperatures and difficulty with breathing.

 

 

- Pressure from intense coughing can cause blood vessels to rupture producing nose bleeds or haemoptysis.

 

 

- Brain damage occurs rarely.

 

 

TREATMENT

 

- Once the disease is established there is no treatment that will alter the course of the illness.

 

 

- A five-day course of antibiotics will kill the bacteria and remove the risk of infecting others.

 

 

PREVENTION

 

- Non-immunised family members who are in contact with pertussis should be given a course of antibiotics to prevent the disease developing.

 

 

- Immunisation against pertussis is part of the triple vaccine given at two, three and four months of age.

 

 

- Breastfeeding does not provide immunity against the disease.

 

 

WEBSITES

 

Health Protection Agency: www.hpa.org.uk

 

 

NHS Direct: www.nhsdirect.nhs.uk

 

 

Prodigy: www.prodigy.nhs.uk

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