Pertussis

What is it

Pertussis is a respiratory infection that manifests itself with violent attacks of dry cough, strong and not controllable by the will, which end with a sound inhalation, assimilated to animal verses, hence the vulgar definition of “asinine, canine or barking cough“.

Causes

Pertussis is caused by Bordetella pertussis, a bacillus present all over the world (50 million cases occur every year and 350 thousand deaths) that preferentially affects humans, even if endowed with the ability to settle in animals such as monkeys and mice.

Pertussis, which is constantly present and has little connection with seasonality, is one of the most contagious diseases: it is transmitted by droplets of saliva that remain suspended in the air. Out of 100 unprotected individuals exposed to contagion, over 90 fall ill.

It is important to underline that the overall course of whooping cough is characterized by re-ignition peaks that tend to repeat cyclically every 3-5 years.

Common symptoms

After the incubation period, of 10-14 days, the course of whooping cough is characterized by an initial phase (catarrhal) with fever, sneezing, hoarseness and nocturnal cough, followed by a period of 2-3 weeks (paroxysmal) of episodes of dry cough (5-15 violent and close blows that end with an “inspiratory scream” and the possible emission of a minimum amount of mucus) and a phase of gradual recovery (convalescence).

Convulsive cough can hinder both breathing and feeding.

Complications

Complications are most serious in the first year of life: bacterial superinfections (otitis, pneumonia, bronchitis), seizures and encephalitis.

Coughing can also cause subconjunctival bleeding and nosebleeds.

The danger of whooping cough is far from negligible: a variable proportion of subjects from one in 1,000 to one in 10,000 can face fatal complications and even in a country like Italy, where the quality of health care can be considered good, 4-10 children die every year from this disease.

Treatment

The treatment is based on antibiotics such as erythromycin (if administered before the paroxysmal period it helps to reduce the contagiousness and sometimes even the extent of the symptoms), and symptomatic drugs (cough suppressants, antispasmodic, anti-inflammatories, according to specific needs).

The pertussis vaccine, which has been around for a few decades now, is now produced by genetic engineering and is well tolerated.

It is available alone or in combination with the diphtheria-tetanus vaccine and is recommended for all infants, who are at greatest risk of complications of the disease. Here’s when it should be administered.

When to see your doctor

Being a contagious disease, the doctor must be consulted at the first suspicious symptoms. Confirmation of the diagnosis relies on demonstrating the presence of the bacterium by culture of nasopharyngeal secretions.