Pertussis

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	Section 1 Section 2 Section 3 Section 4 Section 5 Appendices

The following text is from an archived Red Book^® edition and may not reflect current recommendations or information. To view the current edition, click here.

Section 3. Summaries of Infectious Diseases

Pertussis

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS: Pertussis begins with mild upper respiratorytract symptoms (catarrhal stage) and progresses to cough andthen usually to paroxysms of cough (paroxysmal stage), oftenwith a characteristic inspiratory whoop and commonly followedby vomiting. Fever is absent or minimal. Symptoms wane graduallyover weeks to months (convalescent stage). Disease in infantsyounger than 6 months of age may be atypical; apnea is a commonmanifestation, and whoop often is absent. Similarly, older childrenand adults can have atypical manifestations, with prolongedcough with or without paroxysms and no whoop. The duration ofclassic pertussis is 6 to 10 weeks. Complications include seizures,pneumonia, encephalopathy, and death. Pertussis is most severewhen it occurs during the first 6 months of life, particularlyfor preterm and unimmunized infants. On the basis of cases reportedto local and state health departments (1990–1999), pneumonia,seizures, and encephalopathy occurred in 22%, 2%, and <0.5%,respectively, of infants younger than 12 months of age withpertussis. The case fatality rate was approximately 1% in infantsyounger than 2 months of age and <0.5% in infants 2 to 11months of age. However, because most infants reported to havepertussis are hospitalized, complication rates are likely tobe representative of more severe illness.

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ETIOLOGY: Bordetella pertussis is a fastidious, gram-negative,pleomorphic bacillus. Other infectious agents may cause a similarcough illness: Bordetella parapertussis, Mycoplasma pneumoniae,Chlamydia trachomatis, Chlamydia pneumoniae, Bordetella bronchiseptica,and certain adenoviruses.

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EPIDEMIOLOGY: Humans are the only known hosts of B pertussis.Transmission occurs by close contact via aerosolized dropletsfrom patients with disease. Pertussis occurs endemically with3- to 5-year cycles of increased . . . [Go to Full Text]

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