Whooping cough (pertussis) is a highly contagious respiratory tract infection. In many people, it's marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like "whoop." Before the vaccine was developed, whooping cough was considered a childhood disease. this chart comprises all the major aspects of whooping cough / pertussis please comment thank u

1. PREPARED BY
MARTIN SHAJI
PHARM D
WHOOPING COUGH | PERTUSSIS
(medical information)

2. Discussion about whooping
cough.
Whooping cough is a
dangerous disease, also
discuss the
causes,
symptoms,
and treatment of whooping
cough.

3. What is Pertussis?
Whooping Cough
Whooping cough is a respiratory disease
caused by a bacteria called Bordetella
Pertussis. Very contagious for people who
find themselves not immunized, whooping
cough might be critical in infants and frail
people. The therapy is based on taking
antibiotics. Vaccination can defend you
from pertussis, however, it requires many
reminders as a way to be correctly
protected.

4. What is pertussis?
Whooping cough is a highly contagious respiratory infectious
disease. It is because of Bordetella pertussis (Bacillus Bordet
and Gengou), a bacterium that incorporates dioxygen. The germ
multiplies on the ciliated respiratory epithelium (floor layer at the
level of the mucosa) of the trachea and the bronchi. It diffuses
several particular toxins that cause the disease. Inserm1
estimates that each year 300,000 children die from this disease
and 40 million are affected worldwide.
Note: in infants, whooping cough can be very critical, even fatal,
and complications (pneumonia, seizures …) are possible in very
children.

5. A particular and serious form: the pertussis of the infant
“From 1996 to 2012, approximately 10,000 cases of
pertussis occurred in babies under 6 months of age in
France, 18% of whom were admitted to the intensive care
unit. Pertussis remains one of the leading causes of death
from a bacterial infection in infants less than 3 months old,
“says the Vaccination infoservice2 site.
From the neonatal period and in an unvaccinated child, the
risk of contamination by the environment, siblings, or parents
with unusual and unidentified pertussis is high. There is no
maternal-fetal immune protection.
Epidemiology

7. Contamination and incubation time
Contamination takes place by interhuman air (projection of
droplets of saliva during coughing), basically within the catarrhal
part of the disease throughout which the medical indicators should
not but attribute. The danger of contagion decreases rapidly
during the paroxysmal phase but can last for 3 weeks. The source
of contamination is mainly constituted by a preschool or school-
age children, and also by adults and elderly subjects whose
symptoms are often poorly identified. The attack rate is 70-80% if
the contact is close.
The incubation can last between 7 days and 3 weeks. Generally, it
is around 10 days.

8. CAN WE HAVE WHOOPING
COUGH SEVERAL TIMES?
Immunity is not definitive after the disease
and it is possible to contract it several times
in your life, hence the importance of making
vaccination reminders according to the
recommendations. The incidence of
pertussis in early childhood has significantly
decreased thanks to the systematic and not
compulsory vaccination of infants.

9. Pertussis symptoms
THE INCUBATION PHASE
This is the phase of the disease during which the clinical
signs are not yet characteristic. It lasts 1 to 2 weeks. There
are non-specific signs of upper airway infection:
Rhinitis;
Sneezing;
Cough;
Fever;
The cough, rebellious, gradually becomes spasmodic, emetic
(giving nausea or vomiting), increases at night.

10. THE PAROXYSTIC PHASE
This period lasts 2 to 4 weeks. There are spontaneous coughing
fits. Between the fifths, the clinical examination is normal. There
is no fever.
WHAT IS A QUINTE DE TOUX?
Typically, the fifth is defined as the succession of shakes of
expiratory cough (5 to 20, more and more carefully spaced),
resulting in apnea of ​​a few seconds in forced expiration
(cyanosis), followed by a long inspiration. The “resumption” –
noisy – prelude to a new succession of exhalation shakes. The
cycle repeats 5 to 15 times and ends with mucous expectoration
leading to vomiting. We note 15 to 30 fifths per 24 hours.

11. THE DECLINE PHASE
Then begins the decline phase, which lasts three to
four weeks. The fifths are less and less frequent and
less intense. Sputum becomes easier and
mucopurulent. We often note for several months the
transient reappearance of coughing Quintus with noisy
resumption because of nonspecific respiratory
infections.

12. Additional diagnosis, examinations and analyzes
The analysis is based mostly on three criteria: the character of
the cough, the course of the disease, and the identification of
contaminators. It is done via the following exams:
Isolation in 5 days of the bacteria on special Bordetelles special
media (Bordet-Gengou or Regan Lowe). Nasopharyngeal
suction is the best method. Culture must be undertaken within
the first 3 weeks of illness. Its sensitivity is 50 to 60% at the start
of the disease and decreases very quickly on antibiotics;

13. An X-ray pulmonary:
there are alterations parallel to the
depth of the paroxysmal part, harm
to the respiratory tract sometimes
localized ventilation disorders;

14. Bacteriology:
it allows identification of the germ or detection of its genetic
material by PCR (Polymerase Chain Reaction) in respiratory
secretions (direct examination or immunofluorescence on the
aspiration of the nostril and throat). It is the one organic
examination to diagnose whooping cough reimbursed in
France.
Serology makes it potential to increase the analysis of
certainty if the tradition is defective. Always examine two sera
taken Three or four weeks aside to verify the illness as a
result of anti-pertussis antibodies are comparatively late,
particularly in small infants. Several strategies exist:

15. Agglutination (the physique’s particular protection
response, characterized by the gathering in small clusters
of crimson blood cells, microorganisms, or different
components, within the presence of the corresponding
antibody) is insensitive and meaningless in younger folks
infants.
This approach is bare of curiosity for the detection of anti-
agglutinogen antibodies linked to vaccination with
complete vaccines;

16. The ELISA method is more sensitive and particular however
requires samples spaced 2 to three weeks aside
Possible complications
There are several kinds of issues from pertussis:
Mechanical issues associated to the depth of the cough and
intra-thoracic expiratory hyper pressure: ulceration of the
tongue brake, nasal and subconjunctival hemorrhages, rectal
prolapse, hernias, mediastinal and cervical emphysema,
pneumothorax, and so on .;
Undernutrition, malnutrition, dehydration, through the
repetition of vomiting and eating difficulties;

17. Infectious complications:
suppurative otitis, bronchopulmonary infections, acute purulent
bronchitis, atelectasis, bronchopneumonia, pleurisy;
Neurological complications particularly in young children:
convulsions (2.7%) mainly by anoxia or hyperthermia, intracranial
hemorrhages, neurological sequelae secondary to phases of
cerebral anoxia (0.7%). Pertussis encephalitis occurs after 2 or
three weeks and has an extreme prognosis.

18. Differential diagnosis of pertussis
There may be other causes of rebellious cough, the main
symptom of whooping cough, which should not be confused
with this respiratory illness:

19. THE FACTORS OF GRAVITY OF THE
INFANT WHOOPING COUGH
Several factors can make baby’s pertussis worse:
Age less than 4 months;
Eating difficulties and incoercible vomiting;
Consciousness, convulsions;
Swelling of the abdomen;
Vasomotor disorders of the extremities, mottling;
Pertussis treatments

20. Tachycardia (fast heartbeat)> 200 / min;
Freediving apnea (breathing pause),
persistent cyanosis between fifths;
Leukocytosis> 50,000 / mm 3;
Hyperplaquettose> 500,000 / ul;
Hyponatremia (low blood sodium) <130
mM / L, hypoglycemia.

21. CURATIVE TREATMENT
Antibiotic therapy: despite the germ’s
sensitivity to many antibiotics
(macrolides, tetracyclines,
chloramphenicol),
antibiotic therapy does not modify the
course of the disease. Josamycin 50
mg/kg per day for 14 days causes germ
eradication.
Humidifiers, antitussives, sedatives, are
ineffective and contraindicated in young
children;

22. Corticosteroids:
(hydrocortisone, betamethasone) and salbutamol, even
prescribed late, cut back the depth of fifths: they are not in
common use however useful in severe forms;
Ensure good hydration and nutrition;
Ensure an adequate, fractionated food intake; if necessary
energy supplements.
Promote bronchial evacuation and good pulmonary
ventilation: respiratory physiotherapy if it is well
supported.
Isolation and surveillance.

23. PROPHYLACTIC
TREATMENT
Preventive treatment helps prevent
the onset, unfold, or worsening of
the illness. It is essential in the
presence of a newborn or infant
who has come into contact with a
parent affected by pertussis. It
consists of isolation and antibiotic
prophylaxis for 14 days.

24. THE VACCINE
The pertussis vaccine is
useful from the age of 2
months. The vaccination
schedule consists of 3
injections at 2, 4, and 11
months, with a pertussis
vaccine associated with the
vaccines against tetanus,
diphtheria, poliomyelitis,
Haemophilus B, and hepatitis
B.
You can refer this link for a detailed study on all
the vaccines that are available now

25. Also, recalls are recommended at the age of 6, between 11
and 13, and then at 25. Finally, the vaccine is
recommended for all adults who have not been vaccinated
against pertussis for 10 years, in combination with tetanus,
diphtheria, and polio vaccines.