pertussis

Pertussis, also known as whooping cough, is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis.

• It is characterized by a severe, persistent cough that can last for several weeks [4].
• The coughing fits are often followed by a loud, "whooping" sound as the person tries to catch their breath [11].
• Initial symptoms may be similar to those of the common cold, including a runny nose, fever, and mild cough [7].
• However, these symptoms can quickly progress to more severe respiratory problems, especially in young children and infants [2].

The disease is highly contagious and spreads easily from person to person through coughing and sneezing.

• It is most likely to affect young children, but sometimes appears in teenagers and adults [11].
• The risk of complications and hospitalization is higher for infants younger than 6 months old [2].

Prevention and treatment are key.

• The best way to prevent whooping cough is with the pertussis vaccine, which is recommended for children and adolescents [5].
• Treatment typically involves antibiotics to help clear up the infection, as well as supportive care to manage symptoms and prevent complications [3].

Common Cold-Like Symptoms at First

The initial symptoms of pertussis, also known as whooping cough, can be similar to those of a common cold. These may include:

• Runny nose
• Nasal congestion
• Red, watery eyes
• Slight fever (less than 100.4°F)
• Mild, occasional cough

These symptoms usually appear within the first week or two after infection [1][2]. As the disease progresses, more severe symptoms can develop.

Worsening Symptoms

After a week or two, signs and symptoms of pertussis can worsen, leading to:

• Thick mucus accumulation inside the nose and throat
• A persistent cough that may become severe and frequent
• Pauses in breathing (apnea) in babies
• Vomiting after coughing

It's essential to seek medical attention if you or your child experience these symptoms, especially if they worsen over time [3][4].

Early Warning Signs

In infants, the first signs of pertussis can be subtle and may include:

• A runny nose
• Sore throat
• Low-grade fever (less than 100.4°F)
• Mild cough

It's crucial to monitor for these symptoms in young children, as they can quickly progress to more severe complications [5].

Common Symptoms Across All Ages

Regardless of age, the most common symptoms of pertussis include:

• Runny nose
• Sneezing
• Mild cough
• Low-grade fever (less than 100.4°F)

These symptoms can be a sign that you or your child may have contracted pertussis [6][7].

References: [1] - Context result 1: The disease starts like the common cold, with a runny nose or congestion, sneezing, and sometimes a mild cough or fever. [2] - Context result 2: Runny or stuffed-up nose · Low-grade fever (less than 100.4°F) · Mild, occasional cough [3] - Context result 4: Runny nose; Nasal congestion; Red, watery eyes; Fever; Cough. After a week or two, signs and symptoms worsen. [4] - Context result 5: They usually begin as cold-like symptoms including a runny nose, tearing eyes, fatigue and fever. It is not until the disease progresses that it ... [5] - Context result 8: The first signs of whooping cough are similar to a cold, such as a runny nose and sore throat (a high temperature is uncommon). After about a week, you or your ... [6] - Context result 9: What Are the Signs & Symptoms of Whooping Cough? · runny nose · sneezing · mild cough · low-grade fever. [7] - Context result 7: Signs and symptoms · Mild cough · Low grade fever · Runny nose.

Diagnostic Tests for Pertussis

Pertussis, also known as whooping cough, can be diagnosed through various laboratory tests. The preferred methods for diagnosing pertussis are culture and polymerase chain reaction (PCR) testing [3]. These tests are the basis for the CDC definition of a pertussis case.

Recommended Diagnostic Tests:

• Culture: This test involves taking a sample from the patient's respiratory tract and growing it in a laboratory to detect the presence of Bordetella pertussis bacteria [8].
• Polymerase Chain Reaction (PCR) testing: This is a molecular test that detects the genetic material of B. pertussis bacteria [3, 6].

Other Diagnostic Tests:

• Blood tests for antibodies (serology): These tests detect antibodies produced by the body's immune system in response to the infection [7].
• Direct Fluorescent Antibody (DFA) testing: This is a rapid laboratory diagnostic test that provides results within hours, but it is not recommended for confirming pertussis [4].

When to Test:

Only patients with signs and symptoms consistent with pertussis should be tested by PCR to confirm the diagnosis [5]. Testing asymptomatic individuals or those without symptoms is not recommended.

Availability of Diagnostic Tests:

Most reference laboratories provide PCR testing for individuals with suspect pertussis. The MDH Public Health Laboratory (MDH-PHL) also provides PCR testing and culture services [9].

References: [1] Not available in the context. [2] Not available in the context. [3] Context 3 [4] Context 4 [5] Context 5 [6] Context 6 [7] Context 7 [8] Context 8 [9] Context 9

Treatment Options for Pertussis

Pertussis, also known as whooping cough, can be treated with antibiotics to help alleviate symptoms and prevent the spread of the disease.

• Antibiotic treatment: Several antibiotics are available to treat pertussis, including azithromycin, clarithromycin, and erythromycin. These medications kill the bacteria causing the infection and help speed up recovery.
• Preferred agent: Azithromycin is the preferred antibiotic for treating pertussis in patients of all ages. Erythromycin and clarithromycin are not recommended for infants younger than 1 year old.
• Recommended antimicrobial agents: Macrolide antibiotics, such as azithromycin, clarithromycin, and erythromycin, are the recommended antimicrobial agents for treating whooping cough.

Preventive Measures

Exposed family members may be given preventive antibiotics to prevent the spread of the disease. A 14-day course of oral erythromycin is the antimicrobial therapy of choice for patients with pertussis and for close contacts.

Additional Treatments

While not directly related to antibiotic treatment, other medications have been proposed as cough treatments, including corticosteroids, beta2-adrenergic agonists, pertussis-specific immunoglobulin, antihistamines, and possibly leukotriene modifiers. However, these are not the primary focus of drug treatment for pertussis.

References

• [1] Several antibiotics are available to treat pertussis. The most popular are azithromycin, clarithromycin and erythromycin. If you have had ...
• [2] Healthcare providers generally treat whooping cough with antibiotics. There are several antibiotics available for treatment. It's very important ...
• [3] Azithromycin (3-day course not yet approved for treatment of pertussis), 1-5 months: 10 mg/kg/day ...
• [4] A 14-day course of oral erythromycin is the antimicrobial therapy of choice for patients with pertussis and for close contacts.
• [6] Medications. Antibiotics kill the bacteria causing whooping cough and help speed recovery. Exposed family members may be given preventive antibiotics.
• [7] For patients of all ages azithromycin is the preferred agent. Erythromycin and clarithromycin are not recommended in infants younger than 1 ...
• [9] The recommended antimicrobial agents for whooping cough are macrolide antibiotics (for example, azithromycin, clarithromycin, erythromycin).

Pertussis Differential Diagnosis

Pertussis, also known as whooping cough, requires a thorough differential diagnosis to rule out other respiratory infections that may present similarly. The following conditions should be considered in the differential diagnosis of pertussis:

• Viral upper respiratory infection (URI): A common condition that can mimic the early stages of pertussis [9].
• Community-acquired pneumonia (CAP): Pneumonia can cause cough and other symptoms similar to pertussis, especially in older adults or those with underlying health conditions.
• Tuberculosis: TB can present with chronic cough and other respiratory symptoms that may be confused with pertussis [9].
• Asthma: Asthma can cause coughing and wheezing that may be mistaken for pertussis, especially if the patient has a history of asthma.
• Bronchiolitis: This condition is more common in infants and young children and can present with cough and respiratory symptoms similar to pertussis [6].
• Croup: Croup is a viral infection that causes a barking cough and may be confused with pertussis, especially in young children.
• Common cold: The initial stages of pertussis can be mistaken for a common cold or flu-like illness.

Key Differentiating Factors

While the differential diagnosis of pertussis requires consideration of these conditions, there are key differentiating factors that can help distinguish pertussis from other respiratory infections:

• Typical progression through three phases: Pertussis typically progresses through three distinct phases: catarrhal (early), paroxysmal (coughing fits), and convalescent (recovery) [7].
• Persistent cough without fever: A persistent cough is a hallmark of pertussis, especially in the absence of fever [7].

References

[6] January 18, 2023 - Pertussis should be included in the differential diagnosis of protracted cough with cyanosis or vomiting, persistent rhinorrhea, and marked lymphocytosis. [7] January 7, 2021 - Pertussis initially presents similarly to other respiratory infections, such as viral upper respiratory infection, bronchiolitis, pneumonia, and tuberculosis. Key differentiating factors of pertussis include typical progression through the 3 phases and persistent cough without fever. [9] Nov 7, 2024 — Differentials · Viral upper respiratory infection (URI) · Community-acquired pneumonia (CAP) · Tuberculosis.