whooping cough , pertusis , Bordetella pertussis bacteria ,DTP vaccine .

1. Pertusis
 highly contagious acute respiratory tract infection caused
by Bordetella pertussis bacteria .
 Once diagnosed, treatment involves the use of
antimicrobial therapy, particularly macrolide antibiotics .
 Bordetella pertussis, an aerobic, gram-negative
coccobacillus.
 When an infected individual coughs or sneezes, tiny
microbe-laden droplets are expelled into the air and may
be breathed into the lungs by anyone nearby.
Risk factors :
 Unimmunized baby
 Living around unimmunized persons
 Premature babies
 Pt. with underlying cardiac, pulmonary, neuromuscular,
or neurologic diseases .
Pathophysiology :
Inhaled bacterium produce a toxin that severely damages the
cilia and respiratory epithelium that coat the lining of the lungs,
thereby preventing them from clearing airways of pollen,
mucus, and microbial invaders and causing uncontrollable
coughing episodes .

2. Complications :
 Fractured rib
 Abdominal hernia
 Cerebral hemorrhage
 Pneumonia
 Red eye because of rupture in small arterioles
 Pulmonary hypertension
 Seizure
 Dehydration (because of difficulty during feeding )
Signs and symptoms :
 Incubation period 3 to 12 days but can even reach 3
weeks.
 disease itself is 6 to 12 weeks in duration .
 at first and resemble a common cold.
 After a week or two, signs and symptoms may become
more intense
 severe uncontrollable coughing
 prolonged coughing attacks that may provoke vomiting
 blue-tinged facial tissue after cough
 Infants may not cough much at all; instead, they may
struggle to breathe, or may even temporarily stop
breathing.
 The 1st
sign in neonate may be apnea (nelson essential)
 whoop (The forceful inhalation against a narrowed glottis that
follows this paroxysm of cough).
Diagnosis :
 Usually it is clinical
 isolation of B pertussis in cultures of the nose and/or
throat
 chest x-ray for complicated pertussis to pneumonia .

3. treatment :
 supportive therapy (antipyretic , hydration , etc…)
 antibiotics (azithromycin is the 1st
drug of choice in
neonate and infant because it is less side effect and not
associated to cause pyloric stenosis )
azithromycin 10mg/kg /24 hr for 5 days or
 erythromycin 50mg/kg /24 hr for 14 days or
 clarithromycin 15mg/kg/24 hr for 7 days
prevention :
 by vaccination DTaP
 Immunity to B pertussis decreases after 5 to 10 years
following administration of the vaccine(booster dose)
 It is very important for pregnant women and other people
who will have close contact with an infant to be
vaccinated against pertussis.
 DTaP vaccine given in 5 shootes :
At 2 month
At 4 month
At 6 month
At 15 to 18 month
At 4 to 6 years
 Note : All close contacts should receive prophylactic antibiotics for 5 days
(azithromycin) or 7 to 14 days (clarithromycin or erythromycin, duration based on
age).