Whooping cough or pertusis is an acute respiratory infectious disease caused by Bacillus Pertusis involving trachea, bronchi and bronchioles creating intense cough. The patient suffers from fever. Initially the intensity of the cough is very less.
After 8-10 days a series of paroxysmal cough accompanied by sudden in-drawing of breath, producing characteristic “Whooping” sound. That is why this disease is known as Whooping cough.
Whooping cough occurs in all ages, but is predominantly a disease of young age, i.e. below 5 years. Cold weather and colder regions enhance the incidence of disease.
Spread of Disease:
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Since it is an infectious disease it spreads quickly in the early stages of infection. The main source is the nasal discharge and cough. It spreads directly from person to person. Most children catch the infection from class-mates, toys, clothes and other articles used by the patient.
Incubation Period:
It is of seven to fourteen days.
Infective Period:
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Three weeks after symptoms are observed.
Symptoms:
The patient coughs frequently and its severity increases at night. Sometimes the cough is continuous, the child’s face becomes red, lips are blue in colour, loss of appetite, insomnia, and weakness persists.
Stages
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Catarrhal or Pre-Paroxysmal Stage:
Usually lasts about a week during which the child appears to be afflicted with bad cold. Fever is often present, while the cough tends to be very persistent and may be accompanied with vomiting.
Paroxysmal Stage:
(i) During this stage there is no doubt about the nature of disease; paroxysmal attacks of severe coughing occur; child goes blue in the face; holds his breath causing the fear that the child may suffocate; a long, deep inspiration with a loud “whoop” takes place. That is why this disease is called whooping cough.
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(ii) Vomiting is very often present with the cough.
(iii) Thick sticky mucus is expectorated.
(iv) There may be as many as twenty or more of these bouts in a severe attack.
(v) These attacks are especially frequent at night. Duration
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This stage lasts for three or more weeks, the bouts gradually becoming less severe. The younger the child, more severe the disease.
Complications
(a) Broncho-pneumonia,
(b) Bronchieactasis,
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(c) Gastro-enteritis,
(d) Convulsions.
Treatment
(a) In mild cases where paroxysms are few and child’s general health is good, the patient should be kept in the fresh air as much as possible.
(b) In the more severe cases, with frequent paroxysms and fever, the child is put to bed. A well-ventilated room is particularly important in the treatment of whooping cough.
(c) Small frequent light meals immediately after each bout of coughing, otherwise the child may vomit. Routine bottle feeds may have to be abandoned and the infant fed whenever it will take its feeds.
(d) To reduce paroxysm Phenobarbitone, 1/2 gm twice a day (1/4 gm for infants) may be effective.
(e) Convulsions are best treated with oxygen along with Phenobarbitone.
(f) For suspected pneumonia, penicillin is given.
(g) Tertracycline antibiotics are also given if the attacks are very severe.
Immunisation & Prevention
An effective vaccine is available for active immunisation and is combined with diphtheria and tetanus. It is called D.P.T. These injections at a monthly interval are given between the age of 2-3 months, and a booster dose after 2 years. Whooping cough has its highest fatality rate in the first year of life.
If the cough persists, the patient should be segregated, all articles, utensils, toys, clothes, bedding and the room should be disinfected in a proper manner.
Patient should be provided with liquid/semi liquid food and should be guarded against dampness, wind, dust and cold.