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Whooping Cough

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What is whooping cough ?

Whooping Cough: is a contagious bacterial infection caused by Bordetella pertussis affecting the respiratory system. It is characterized by a “whooping” sound while breathing in after an uncontrollable and violent episode of coughing.

Generally, symptoms develop by 5 to 10th day after exposure to the bacteria. At times it may not develop for as long as three weeks.

How does it all happen?

• It is highly contagious disease where the bacterial cells attach themselves to the hair-like tiny extensions (cilia) covering the upper respiratory system.

• There is release of toxins which damage the cilia causing inflammatory changes in the airways.

Causes:

• It is a highly contagious bacterial infection caused by bacterium Bordetella pertussis.One person can transmit to approximately 12-17 individuals.

• The bacterial spread happens from person to person

• Tiny drops of fluid from the nose or mouth of an infected person spread the infection.

• The spread is airborne; hence it can spread when the infected person sneezes or coughs.

• Poor hand hygiene can also lead to the spreading of the infection.

• The most contagious period is during the earliest stages, which can last up to about 2 weeks after once coughing spells begin.

• Antibiotics have shown to shorten this period to 5 days after start of treatment.

Symptoms:

There are two phases of symptoms, early and late. Early phase lasts for 1 to 2 weeks and late phase generally starts after 2 weeks and can last up to 10 weeks.

Recovery / Convalescent: there is a decrease in the rate of coughing, and the person returns to being healthy.

Alarming signs:

• If fever is higher than 1020F/ 38.80C .

• Nausea/ Vomiting

• Bluish discoloration of fingers, skin or nails (cyanosis)

• Compromised breathing / severe difficulty in breathing

Complications:

In individuals of all ages, when there is a delay in diagnosis and treatment of whooping cough, it may lead to complications. These complications may vary occurring to the age of an individual.

In babies less than 1 year of age

• Paused breathing / apnea (61%)

• Develop pneumonia (23%)

• Convulsions/ fits (1.1%)

• Encephalopathy (0.3%)

• Death (1%))

• Dehydration

In children and adults

• Rib fracture

• Loss of bladder control

• Weight loss

• Difficulty in sleeping

• Pneumonia

• Abdominal hernias

• Broken blood vessels in skin or the eyes (white part/sclera)

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Diagnosis:

Eliciting a good history regarding the condition along with required diagnostic tests, makes it easy to diagnose and treat whooping cough.

Prevention:

• Vaccines: take the three doses at 2, 4, 6 months of age, followed by booster dose at 18 months and 5 years of age.

• Increase intake of warm liquids/ drinks.

• Keep air moist

• Maintain good hand hygiene, wash hands for 20 seconds. Use alcohol based sanitizers to clean hand if soap and water not available.

• Cover mouth and nose and cough or sneeze into your elbows.

• Take preventive antibiotics if anyone known or in the family has been exposed to the disease.

Treatment:

The treatment of whooping cough includes antibiotics, bronchodilators and good precautionary methods to prevent the spread.

• Macrolide antibiotics are drug of choice

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