All About Whooping Cough

Whooping cough (also termed pertussis or 100-day cough) is a respiratory infection of bacterial origin. Pertussis is a highly infectious disease that causes severe, uncontrollable cough fits that make breathing difficult.

You should reach out to a Pulmonologist in Lahore for consultation if you suspect a respiratory illness of this sort.

Prevalence

Pertussis is a leading cause of morbidity and mortality in children under the age of two. It affects roughly 48.5 million people worldwide per year. The infant mortality rate precipitated by whooping cough has been estimated to be 4 percent in developing regions. 

However, owing to the increasing success of immunization programs, there has been a significant reduction in the global burden of this disease. 

Studies also display a predisposition of this illness to females.

How Can You Contract This Infection: Causes & Risk Factors

Bordetella pertussis and Bordatella parapertussis are the most frequently associated causative agents with this respiratory illness, with the latter producing an infection of relatively milder intensity. This disease is transmitted through the aerosolized respiratory droplets of infected individuals if you come into contact with it.

Whooping cough is a toxin-mediated disease where the bacteria lands onto the ciliary epithelium for attachment and paralyzes the ciliary motion by releasing its toxins. The persistently inflamed epithelium produces mucopurulent secretions in the bronchopulmonary tract which the static cilia fail to expel out of the deeper passages. The constant accumulation results in severe chest congestion and frequent aggressive bouts of cough.

Cough is more likely to affect premature babies and people with weakened immunity due to underlying cardiac, pulmonary, or neurological issues. If you have an incomplete vaccination history, if you are pregnant, or have had prior exposure to an infected individual, these account as high-risk variables.

Sign & Symptoms

Whooping cough has a 5-10 day incubation period. Symptoms can take up to 3 weeks to appear in certain cases. There are three stages to the disease: catarrhal, paroxysmal, and convalescent which are spaced out across 100 days.

Catarrhal/ Early Phase (comparable to normal cold):

• Low-grade fever (below 102 F)
• Mild cough
• Nasal congestion
• Rhinorrhea
• Sneezes

Paroxysmal/ Late Phase (most severe):

• Progressively deteriorating cough
• Paroxysms of sudden, uncontrolled, violent coughing spell accompanied by a “whoop” sound of high pitch
• Post-tussive emesis
• Cyanotic skin around the mouth
• Dehydration
• Breathlessness
• Conjunctival hemorrhage (in chronic cases)
• Facial petechiae (in chronic cases)

Convalescent Phase:

• Dry chronic cough that may last up to weeks

Treatment

As pertussis is highly contagious, it is recommended to isolate the infected person to minimize transmission. The first-line treatment is an antimicrobial therapy with erythromycin, clarithromycin, and azithromycin as the preferred therapeutic agents.

Patients who experience dysphagia (difficulty in swallowing) are placed on intravenous replacement therapy for electrolytes and fluid. Unfortunately, over-the-counter antitussives also prove to be ineffective and may rather put infants at risk for serious adverse effects.

Many physicians recommend the use of humidifiers to maintain the moisture of the surrounding air which reduces the chances of incurring violent cough bouts.

Complications

Infants can manifest complications that include:

• Apnea
• Bleeding in the brain
• Brain damage
• Convulsions
• Encephalopathy
• Pneumonia
• Seizures
• Death

In the case of adults, the following are the probable complications:

• Abdominal hernias
• Broken blood vessels
• Pneumonia
• Pneumothorax
• Refractory pulmonary hypertension
• Rectal prolapse
• Rib bruises
• Rib fracture from violent cough bouts
• Subdural hematomas
• Syncope
• Trouble sleeping
• Urinary incontinence
• Weight loss

What Can You Do To Prevent It?

Despite a running treatment, combatting pertussis through immunization is the single most effective prevention method. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) both strongly advocate a routine vaccination schedule (CDC) to prevent infectious diseases. 

One of the variants of pertussis vaccine is known as DTaP that follows a regimen of 2, 4, and 6 months after birth. The boosters are administered at 15-18 months, 4-6 years, and 11 years. The other type, Tdap is recommended for individuals aged 7 and above, up to adulthood, usually with an incomplete immunization history. If you are a pregnant woman, routine vaccination is still indicated for you irrespective of your past vaccination status.

Who Do I Contact?

Whooping cough necessitates keen health surveillance in infected individuals to avert potential complications stemming from a hypoxic state. You must immediately seek medical help from a Pulmonologist in Islamabad who can provide you with a treatment regimen best-suited for you.