Pertussis, or whooping cough, is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. It is characterized by severe coughing fits that can cause vomiting. While it presents differently in different age groups, the classic symptoms include a progression through catarrhal, paroxysmal cough, and convalescent stages. Complications are most common in infants and young children and can include hypoxia, pneumonia, and neurological damage. Diagnosis involves clinical presentation along with lab tests. Treatment involves antibiotics and supportive care. Prevention focuses on vaccination, though it is not fully protective.

1. Pertussis

2. • Highly contagious respiratory infection
• Classic pertussis, the whooping cough
syndrome, usually is caused by B. Pertussis
• a gram-negative bacillus with fastidious
growth requirements
• Bordetella parapertussis, which causes a
similar but milder illness that is not affected
by B. pertussis vaccination
• Transmission:person to person by coughing.
• Adenoviruses have been associated with the
pertussis syndrome.

3. EPIDEMIOLOGY
• Outbreaks first described in 16th century
• Bordetella pertussis isolated in 1906
• Estimated >500,000 deaths annually
worldwide

4. Pertussis Epidemiology
• Reservoir Human
Adolescents and adults
• Transmission Respiratory droplets
Airborne rare

5. CLINICAL MANIFESTATIONS
• Incubation period 3-12 days (up to 21 days)
• Insidious onset, similar to minor upper
respiratory infection with nonspecific cough
• Fever usually minimal throughout course
• Apnea & Cyanosis in infant

6. Pertussis Clinical Features
• Catarrhal stage 1-2 weeks
• Paroxysmal
cough stage 2-4 weeks
• Convalescence Weeks to
months

7. Pertussis Clinical Features
Stage 1 :
Rinorrhea’Lacrimation’Conjectival Injection’Mild cough’’Low
grade fever’
Stage 2:
Severe cough’Whoop’Cyanosis’Red face’
Vomiting
Stage 3:
Decrease Cough & Vomiting’Chronic cough

8. • Young infants may not display the classic
pertussis syndrome
• the first signs may be episodes of apnea.
• Young infants are unlikely to have the classic
whoop
• are more likely to have CNS damage as a result
of hypoxia
• Adolescents and adults with pertussis usually
present with a prolonged bronchitic

9. Bilateral scleral hemorrhages and periorbital edema in a young
boy with pertussis.

11. Ecchymoses and conjunctival hemorrhage in a 6-year-old
unimmunized child with pertussis

12. Diagnosis:
History &P/E
Leuckocytosis (Lymphocytosis)
Culture(Nasopharengeal swab)
Direct Flurocent Antibody , PCR
(Nasopharengeal)
Perihilar Infiltration’…signs of segmental lung
atelectasis

13. Differential Diagnosis:
• Pneumonia
• Asthma
• RSV, parainfluenza virus, and C. pneumoniae
• TB
• CF
• Foreign body
• Bronchiolitis
• Mediastinal Lymphadenopathy

14. COMPLICATIONS
• Major complications are most common among infants
and young children:
hypoxia, apnea, pneumonia, seizures, encephalopathy,
and malnutrition
• The most frequent complication is pneumonia
• Atelectasis may develop secondary to mucous plugs.
• The force of the paroxysm may rupture alveoli and
produce pneumomediastinum pneumothorax, or
interstitial or subcutaneous emphysema
• epistaxis; hernias; and retinal and subconjunctival
hemorrhages

15. Treatment
• Erythromycin 50 mg/kg/D PO (14 DAY)
• Azithromycin , clarithromycin ,TMP-SMZ
• Salbutamol
• Moist O2
• Nasopharengeal suction
• IV Fluid
• No Immunoglobulin’No Antitussive drugs’No
Steroid

16. PREVENTION
• Pertussis vaccine has an efficacy of 70% to 90%
• Erythromycin and other macrolides are effective in
preventing disease in contacts exposed to pertussis
• Close contacts older than age 7 should receive
prophylactic macrolide antibiotic for 10 to 14 days,
but not the vaccine