Pertussis is a disease that occurs when the bacterium Bordetella pertussis infects the respiratory system. Although it was known as a childhood disease in the past, it has been seen that it can affect all age groups today.
What is whooping cough?
It is known that pertussis disease caused by B. pertussis, which mainly affects the respiratory system, has been spreading in local epidemics from time to time since the 1700s. The causative bacterium was first isolated in 1906. Isolation of the bacterium is an important step for the development of vaccines in the future. However, it is still seen as an important public health problem in some developing countries. About 150,000 cases have been reported annually worldwide. According to the World Health Organization data, the number of pertussis cases seen in our country in 2019 is 60.
What Causes Pertussis?
The bacterium Bordetella pertusis enters the body through respiration. It comes to the nasopharynx, which is called the junction of the nose and throat. In this region, it attaches to the epithelium (surface cover) lining the respiratory tract. It causes damage to the epithelium it attaches to, through the toxins (poisons) it secretes. It begins to multiply in the damaged area.
It neutralizes the cells of the immune system that are responsible for recognizing foreign substances and removing them from the body. At the same time, it enters these cleansing cells and continues its life here. For all these reasons, it cannot be removed from the body and becomes permanent. The toxins it secretes cause swelling of the airways and excessive mucus formation, making it difficult to breathe. Sick people often cough to expel this mucus and breathe easily.
What are the Symptoms of Whooping Cough?
Symptoms of pertussis may vary according to age. While the disease progresses more typically in preschool and school-aged children, the symptoms of pertussis in adults may be variable.
Symptoms of the disease begin 10 days after being infected with Bordetalla pertussis. Nasal congestion and runny nose, which may be confused with a cold at first, flushed g extracts, fever and cough are frequently seen in patients.
After the disease progresses for 1-2 weeks, the cough starts to become more frequent and severe. There may be 5-10 consecutive coughs and cough-related vomiting at one time. At the end of recurrent coughs, the mucus blocking the airways can be expelled like a plug. At this time, a sound as if suffocating is heard. This is how a classic whooping cough happens.
The person can be seen as normal except for cough attacks. During coughing, bruising may be observed due to insufficient respiration. The number of attacks can vary from person to person. There may be coughing attacks that are strong enough to wake them from sleep. Symptoms such as weight loss due to decreased appetite and gradually increasing fatigue are also common. The disease gradually regresses within 1-3 months.
What are the Harms of Pertussis?
Some complications develop in pertussis, especially due to severe coughing. These complications are more common in young children.
Increased intra-abdominal pressure during coughing can cause hernias in the abdomen and groin. It can cause bleeding in the form of small red dots on the face and body, and bleeding in the layers inside the eye.
Tough and severe coughing attacks may cause rib fractures.
Seizures may also be observed in children treated for pertussis.
Pertussis is a disease with serious complications. It can even affect the nervous system. People with symptoms similar to pertussis symptoms should apply to the nearest health institution and have the necessary tests done and if they need treatment, they should be treated without interruption.
How is Pertussis Transmitted?
Pertussis is a disease that only occurs in humans. It is only transmitted from person to person. The disease is transmitted through the respiratory route. Persons infected with Bordetella pertussis; When they cough or sneeze, they transmit the disease to people with whom they share the same space or spend a lot of time.
Babies are most susceptible to the disease. flour; It can be caught by siblings, parents, caregivers.
When it is most contagious, it is the 2 weeks after the onset of cough.
Antibiotic treatment can shorten the contagious period of the disease.
Pertussis can be passed without any symptoms in adults. It is recommended that occupational groups who come into contact with young children should be careful in this situation and get vaccinated if necessary. Since the disease is transmitted through the respiratory tract, places such as kindergartens and nursing homes where many children are together in a closed area; It is very risky for the spread of the disease.
How Many Days Does Pertussis Last?
Although the duration of pertussis varies from person to person, all stages cover a period of approximately 2-3 months.
How is Pertussis Diagnosed?
It is of great importance that the patient has classical pertussis symptoms in the diagnosis. However, since these symptoms may not be seen in older children and adults, the diagnosis should be confirmed with additional tests. Physical examination is also a method that should be done for the diagnosis of pertussis. It may be useful to examine and culture a swab taken from the back of the throat by entering through the nose. In addition to these, basic tests such as blood test also play a role in demonstrating the presence of infection.
Pseudo-pertussis; It is a situation where symptoms such as cough, vomiting, and weakness are similar to pertussis, but the cause of the disease is various viruses, not B. pertussis.
How is the Treatment of Pertussis?
Antibiotics are used in the treatment to clear the bacteria causing the disease from the respiratory tract. used. Unless the treatment is started in the first stage when the symptoms are mild, there is no change in the course of the disease. Macrolide group antibiotics are the first choice in the treatment.
Pertussis causes severe cough, but cough suppressants have been found to be ineffective in the treatment.
Small infants with a high risk of pertussis causing death and patients with severe disease require hospitalization. They are allowed to stay in rooms with respiratory isolation in the hospital.
What is Pertussis Vaccine?
Pertussis vaccine provides primary protection for the disease. In infants, the donation that will recognize the bacteria before the B. pertussis bacteria is encountered It allows the formation of click system cells. In this way, babies who encounter this bacteria in the future will recognize the bacteria very quickly and will remove the bacteria from the body with the help of their immune system.
The protection of the vaccine is not 100%. In other words, the probability of pertussis in people who have been vaccinated is not reset. However, it has been observed that the disease progresses milder in people who are sick despite being vaccinated.
When is the Pertussis Vaccine Given?
Whooping cough vaccine; Diphtheria, tetanus, inactivated polio and Hemophilus influenza type b vaccine together with the Five Combination Vaccine is administered as 3 doses at the end of the 2nd, 4th and 6th months. Quadruple Combination Vaccine containing; It will be held in children born after July 1, 2016 and in their 48th month. In children born before this date, the Quadruple Mixed Vaccine will be administered as school vaccination during the education period.
Pertussis vaccine, which is included in the vaccination calendar of our country, is provided to all children free of charge by the state. In order to protect your child from pertussis, it is recommended that you get the vaccines appropriately.
What to Do When Contacting Someone Who Has Pertussis?
As a result of contact with a person known to have whooping cough;
- Pregnant
- Healthcare workers
- Infants under 12 months of age
- People with weakened immune systems
- As asthma affecting the respiratory system In those with the disease
- In those who live with a pertussis patient
- In those who are likely to develop serious complications as a result of whooping cough disease, antibiotic treatment may be started as a precaution.
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