Pertussis, also known as whooping cough, is caused by the bacteria Bordetella pertussis. It is endemic and occurs in epidemics every 3-4 years, peaking in summer and fall. It is highly contagious and spreads through airborne droplets. Clinical features include an initial catarrhal stage with mild cough followed by paroxysmal stage with repetitive coughing fits and a characteristic whoop. Diagnosis is based on clinical presentation and can be confirmed with lab tests like lymphocytosis, ELISA detecting antibodies to pertussis antigens, or DNA probe/PCR on secretions.

1. PertusisPertusis
 Soumya Ranjan ParidaSoumya Ranjan Parida
 Basic B.Sc. Nursing 4Basic B.Sc. Nursing 4thth
yearyear
 Sum Nursing CollegeSum Nursing College

2. IntroductionIntroduction
Sydenham-1670Sydenham-1670
Agent-Bordetella PertusisAgent-Bordetella Pertusis((pleomorphic,fastidious,non-motile,gram –pleomorphic,fastidious,non-motile,gram –
ve,coccobacili,grows best on B.G media)ve,coccobacili,grows best on B.G media)
Pertusis like illnessesPertusis like illnesses
B.parapertusisB.parapertusis
B.bronchisepticaB.bronchiseptica
MycoplasmaMycoplasma
Adeno virus -1,2,3,5Adeno virus -1,2,3,5
R.S.VR.S.V
Parainfluenza & influenza virusesParainfluenza & influenza viruses
EnterovirusesEnteroviruses

3. EpidemiologyEpidemiology
Endemic, epidemic every 3-4 yearsEndemic, epidemic every 3-4 years
Peak season-July - OctoberPeak season-July - October
Strike rate-80-100 %Strike rate-80-100 %
Host –Host –more serious in females, younger agemore serious in females, younger age(50-70% cases<1 yr with most deaths)(50-70% cases<1 yr with most deaths)
Maternal abs.-not protectiveMaternal abs.-not protective
immunity wanes –subclinicalimmunity wanes –subclinical
Reservoir( asymptomatic carriers )Reservoir( asymptomatic carriers )
Spread airborne droplet , direct contactSpread airborne droplet , direct contact
Infectivity-till cough stops /7 day erythromycinInfectivity-till cough stops /7 day erythromycin

4. PathogenesisPathogenesis
Biologically active substances produced by B.pertusisBiologically active substances produced by B.pertusis
FHA (filamentous hemagglutination factor)FHA (filamentous hemagglutination factor)
LPF / PT / PertectinLPF / PT / Pertectin
Adenyl cyclaseAdenyl cyclase
DemonecretinDemonecretin
Tracheal cytotoxinTracheal cytotoxin
Endotoxin (not imp.)Endotoxin (not imp.)
Attachment on resp.epi.- toxin - peribronchial congestion +Attachment on resp.epi.- toxin - peribronchial congestion +
mucosal edema +infiltration of lympho.- patchy areas ofmucosal edema +infiltration of lympho.- patchy areas of
atelectasis & hyperinflation- v/p mismatch-hypoxia,atelectasis & hyperinflation- v/p mismatch-hypoxia,
secondary infectionsecondary infection

5. Clinical featuresClinical features
IncubationIncubation – 6-20 days (mean 7 days)– 6-20 days (mean 7 days)
Clinical stagesClinical stages
Catrrhoeal -Catrrhoeal -1-2 weeks, low grade fever , rhinorrhoea ,mild cough1-2 weeks, low grade fever , rhinorrhoea ,mild cough
Paroxysmal-Paroxysmal- 2-4 weeks, repitative bouts ,whoop ,post tussive emesis2-4 weeks, repitative bouts ,whoop ,post tussive emesis
non life threatening bout-non life threatening bout- <45 sec.red color change,tachycardia /<45 sec.red color change,tachycardia /
bradycardia not < 60 ,oxygen desaturation resolves spontaneouslybradycardia not < 60 ,oxygen desaturation resolves spontaneously
ConvalescentConvalescent

6. DiagnosisDiagnosis
Typical clinical pictureTypical clinical picture-H/O contact,cough > 2 weeks-H/O contact,cough > 2 weeks
whoop , posttussive emesiswhoop , posttussive emesis
InvestigationsInvestigations
TLC- lymphocytosisTLC- lymphocytosis
ESR- decreasedESR- decreased
Fluroscent stain of secretionsFluroscent stain of secretions
CIEPCIEP
ELISA- detects ab.FHA ,PT IgG-PT most specificELISA- detects ab.FHA ,PT IgG-PT most specific
DNA probe ,PCR.DNA probe ,PCR.

7. DiagnosisDiagnosis
Typical clinical pictureTypical clinical picture-H/O contact,cough > 2 weeks-H/O contact,cough > 2 weeks
whoop , posttussive emesiswhoop , posttussive emesis
InvestigationsInvestigations
TLC- lymphocytosisTLC- lymphocytosis
ESR- decreasedESR- decreased
Fluroscent stain of secretionsFluroscent stain of secretions
CIEPCIEP
ELISA- detects ab.FHA ,PT IgG-PT most specificELISA- detects ab.FHA ,PT IgG-PT most specific
DNA probe ,PCR.DNA probe ,PCR.