Communicable Disease : Community Nursing

1. Pertussis
(aka Whooping Cough)
Autumn Lucas, RN

2. Incidence
• Contagious Respiratory Illness
• Cases reported weekly by states to CDC
• Average annual incidence: 3.3 cases/100,000
population
• Approximately 14,000 reported cases in US
in 2008

3. Prevalence
• Of 14,000 reported cases, 54% were
females, 23% were in children <1 year of
age, whites twice as likely to be infected as
African-Americans, and Hispanic ethnicity
accounted for nearly half of confirmed
cases
• States with highest reported cases:
Massachusetts and California

4. Pertussis: Rates of Infection

5. Causes
• Bacteria: Bordetella Pertussis
• Highly contagious respiratory illness
• Bacteria attaches in upper respiratory
system and causes inflammation by
releasing toxins and damaging cilia

6. Transmission
• Found only in humans
• Spread by coughing and sneezing
• Infants often exposed by parents or older
siblings

7. Early Signs/Symptoms
• Cold-like s/s
• Mild cough
• Low Grade Fever
• Usually develop within 7-10 days of
exposure, sometimes up to 6 weeks after
exposure

8. Advanced Signs/
Symptoms
• Persistant cough lasting for weeks (10+)
• Severe, violent coughing fits (paroxysms)
• Apnea (especially in infants)
• Vomiting
• Exhaustion

9. http://www.pkids.org/
diseases/pertussis.html

10. Complications
• 50% of infants have to be hospitalized
• Risks of pneumonia, convulsions, apnea,
weight loss, syncope, rib fractures from
severe coughing, encephalopathy, and death

11. Diagnosis
• History of s/s
• Physical Exam
• Lab test of secretions from swab to back of
throat (through the nose)
• Blood Test

12. Bordetella Pertussis

13. Treatment/Prognosis
• Antibiotics - must be given early to prevent
spreading of disease and to limit severity of
coughing
• S/S outlast bacteria, so antibiotics will not
be given after early stage has passed
• Ex: Erythromycin, Azithromycin
(Zithromax)

14. Treatment Continued
• Keep home free of irritants such as dust,
smoke, and chemicals
• Use cool mist vaporizor
• Handwashing
• Small, frequent meals
• Increased PO fluid intake

15. Prevention
• Vaccination is the best way to prevent
pertussis in all ages
• DTaP combination vaccine - series of 5
shots given at ages 2 mo, 4 mo, 6 mo, 15-18
mos, and between ages 4-6.
• Tdap immunization for teens and adults
• Limit contact with infected individuals

16. References
• http://www.cdc.gov/
• http://rankingamerica.wordpress.com/
2010/11/11/the-u-s-ranks-4th-in-pertussis/