Definition The bacteria Bordetella pertussis causes pertussis, a respiratory illness characterised by severe episodes of cough.
What is going on in the body? Pertussis is spread from person to person through respiratory secretions. The time between when a person is exposed to pertussis and when symptoms begin is usually 1 to 2 weeks. The disease begins with mild cold like symptoms, but can progress to severe episodes of coughing. In young children, the episodes of coughing are followed by a characteristic whooping sound when breathing in. Patients will sometimes vomit after a coughing episode.
The disease is most severe in young infants. It can be associated with apnoea, or long periods without breathing, and respiratory arrest. The main symptom in older children and adults is often just a cough that lasts a few weeks to months. The disease has become much less common with routine use of the pertussis vaccine over the past 60 years.
What are the signs and symptoms of the infection? Signs and symptoms of pertussis include:
sneezing and nasal congestion.
tearing from the eyes.
loss of appetite.
a hacking cough. The hacking cough is then followed by explosive coughs that end in a high pitched whoop, young infants often do not develop a whoop.
Emergency symptoms include difficulty breathing and blue lips. A doctor should be contacted immediately if these symptoms occur.
What are the causes and risks of the infection? Bordetella pertussis causes pertussis.
What can be done to prevent the infection? The pertussis vaccine prevents infection with Bordetella pertussis in almost all cases. Common side effects of the vaccine are fever and redness, swelling, and pain at the site of the injection. These side effects are much less common now that the acellular vaccine is used routinely. Rare side effects include an allergic reaction and febrile seizures.
A person in close contact with an individual with pertussis should take antibiotics to prevent the disease. This is true even for persons who have been vaccinated, because the vaccine is not 100% effective.
How is the infection diagnosed? Bordetella pertussis can be cultured from a sample of mucous from the nose. It usually takes about 2 weeks to obtain a culture result. In addition, special antibody stains can be used to detect the organism in 1 to 2 days.
What are the long-term effects of the infection? For months afterward, even a mild upper respiratory infection, such as a cold, can cause prolonged coughing spells.
What are the risks to others? Pertussis can be spread to those who have not been immunised, through respiratory secretions of an infected person. Erythromycin may be prescribed for family members, particularly those under 2 years old. The pertussis vaccine is the best method of preventing risks to others.
What are the treatments for the infection? Erythromycin, an antibiotic, is given to treat the infection. If given very early in the course of the disease, it may lessen the symptoms. If given later, it has no effect on the disease, but it will decrease the risk of spreading the disease to others.
What are the side effects of the treatments? The main side effects of erythromycin are abdominal cramping, nausea, vomiting, and diarrhoea.
What happens after treatment for the infection? As the person recovers from pertussis, the coughing and vomiting gradually subside.
How is the infection monitored? Once pertussis has subsided, a person should no longer need monitoring. A person who has had pertussis may find they are more susceptible to respiratory infections for a few months.
Author: John Wegmann, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
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