From the Guidelines
Pertussis, or whooping cough, is caused by the bacterium Bordetella pertussis, a fastidious Gram-negative coccobacillus that elaborates toxins damaging respiratory epithelial tissue and having systemic effects. The symptoms of pertussis can vary, but according to a study published in Pediatrics 1, when pertussis is recognized and confirmed in adolescents, 72% to 100% report paroxysmal cough, difficulty breathing, and difficulty sleeping.
- Key symptoms include:
- Paroxysmal cough
- Difficulty breathing
- Difficulty sleeping
- Posttussive vomiting (in 50% to 70% of cases)
- Whoop (in 30% to 65% of cases)
- The disease can lead to significant morbidity, with 1% to 2% of adolescents being hospitalized, having pneumonia, or experiencing a rib fracture, and 0.2% to 1% having a seizure or losing consciousness 1.
- The duration of coughing can be prolonged, with 97% of adolescents coughing for 3 weeks or longer, and 47% coughing for more than 9 weeks, as found in a study in Quebec, Canada 1.
- Early diagnosis and treatment are crucial to reduce the risk of transmission and prevent long-term complications, although even when recognized, delayed treatment and postexposure prophylaxis have little to no effect 1.
From the Research
Whooping Cough Symptoms
- The symptoms of whooping cough include paroxysmal cough with a characteristic whoop and vomiting 2
- The disease can occur at any age, leaving only short-term immunity 3
- Depending on age, vaccination status, and distance to pre-infection with B. pertussis, whooping cough shows a wide range of symptoms 3
- Severe complications and deaths occur mostly in infants 2
Causative Organism
- Whooping cough is caused predominantly by the gram-negative bacterium Bordetella pertussis 3, 2
- Other Bordetella species such as B. parapertussis and B. holmesii can also cause whooping cough-like diseases 3
- B. parapertussis can cause a similar, but usually less severe pertussis-like disease 2
Treatment and Prevention
- Macrolides such as azithromycin and clarithromycin are regarded as antibiotics of first choice for treating whooping cough 3
- Childhood vaccination is safe, effective, and remains the best control method available 2
- Many countries have replaced whole-cell pertussis vaccines (wP) with acellular pertussis vaccines (aP) 2
- Maternal immunisation programmes have also demonstrated high efficacy in preventing hospitalisation and death in infants by passive immunisation through transplacental transfer of maternal antibodies 2