Pertussis (Whooping Cough)

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	Section 1 Section 2 Section 3 Section 4 Section 5 Appendices

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Section 3. Summaries of Infectious Diseases

Pertussis (Whooping Cough)

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 similar to the common cold (catarrhal stage)and progresses to cough and then usually to paroxysms of cough(paroxysmal stage) characterized by inspiratory whoop and commonlyfollowed by vomiting. Fever is absent or minimal. Symptoms wanegradually over weeks to months (convalescent stage). Diseasein infants younger than 6 months of age can be atypical witha short catarrhal stage, gagging, gasping, or apnea as prominentearly manifestations; absence of whoop; and prolonged convalescence.Sudden unexpected death can be caused by pertussis. Diseasein older children and adults also can have atypical manifestationswhen the cough is not accompanied by paroxysms or whoop. Theduration of classic pertussis is 6 to 10 weeks in children.Approximately one-half of adolescents with pertussis cough for10 weeks or longer. Complications among adolescents and adultsinclude syncope, sleep disturbance, incontinence, rib fractures,and pneumonia. Pertussis is most severe when it occurs duringthe first 6 months of life, particularly in preterm and unimmunizedinfants. Complications among infants include pneumonia (22%),seizures (2%), encephalopathy (<0.5%), and death. On thebasis of cases reported to local and state health departments(1990–1999), the case fatality rate was approximately1% in infants younger than 2 months of age and <0.5% in infants2 to 11 months of age. Rare pertussis deaths at older ages occurin people with underlying conditions, especially neuromusculardisorders.

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ETIOLOGY: Pertussis is caused by a fastidious, gram-negative,pleomorphic bacillus, Bordetella pertussis. Other causes ofprolonged cough illness include Bordetella parapertussis, Mycoplasmapneumoniae, Chlamydia trachomatis, Chlamydophila pneumoniae,Bordetella bronchiseptica, and certain respiratory tract viruses,particularly adenoviruses . . . [Go to Full Text]

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