Whooping Cough: Causes, Symptoms, Treatment, and Prevention
whooping cough is an infectious and communicable disease involving the tracheobron. The disease is characterized by the respiratory tract with spasmodic attacks of coughing frequently ending in a crowing or inspiratory whoop. The course of the disease is long-drawn and distressing, usually lasting 1-3 months.
The disease interferes with nutrition, and complication like bronchopneumonia is common in infants_ Case fatality rate is about 0.5% but the death rate is appreciably high below 1 year of age. In the developing countries the importance of this disease still remains an enigma, for although the evidence from epidemiological studies indicates that whooping cough causes many deaths, the evidence from clinical sources does not confirm this. This is perhaps due to the fact that in the first few months of life the clinical pattern of this disease is somewhat different and as such goes unrecognized on presentation. Consequently, 30%-40% case fatality occurs in this age group. who die of apnoea and cyanosis causing respiratory failure.
The reporting of whooping cough is grossly inadequate. The annual incidence of pertussis in India is around 587 per 100.000 population as compared to 2.2 cases per 100.000 population in North America.
Complications. Epistaxis. subconjunctival and other hemorrhages, hernia, prolapse rectum. bronchopneumonia and bronchiectasis may occur in children.
Sequelae. Cardiac dilatation and tuberculosis.
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Epidemiology of Whooping cough
Occurrence: Whooping cough is prevalent all over the world and usually occurs in endemic form. In large communities occasionally epidemics are seen to appear every few years. Agent: The causative organism is B. pertussis. It is small. non-motile gram-negative bacillus. It is destroyed by drying, exposure to ultra-violet light and at a temperature of 55°C. In a small percentage of cases, B. parapertussis is probably responsible. Host: The disease is common in children. Most cases occur at ages between 1 to 8 years and only a few cases occur after 12 years. Infants under 6 months of age are also affected, unlike other communicable diseases. All races are equally susceptible and females suffer more than males. One attack confers durable immunity and further attacks are rare. Environment: It may occur at any time of the year, but the incidence is higher during winter months. Reservoir: Healthy carriers are unknown. Man is the reservoir and the source of infection is the respiratory discharges. Mode of transmission: It is spread by contact with infected persons, by droplet infection and indirectly by contaminated fomites. Whooping cough is infectious from the onset of the catarrhal stage to three weeks after the typical paroxysms set in. It is most infectious during the catarrhal and early paroxysmal stage and it may be transmitted during the later part of the incubation period. Incubation period: Commonly 7 to 10 days, and rarely exceeding 14 days.
Whooping cough Diagnosis
|Diagnosis can frequently be made from clinical features. Culture of the organisms. on cough plates or from the nasopharyngeal swab, establishes the diagnosis. An ELISA test may be helpful in diagnosis when other tests are negative.|
Prevention and Control of Whooping cough
Active immunization is the best way of preventing the disease. The currently used pertussis vaccine has been found to be quite.