What is Pertussis?

  • Infection of the trachea caused by Bordatella Pertussis virus.
  • Mainly affects infants and young children.
  • Spread through exposure to affected people and through air droplets.
  • Characterized by paroxysms of coughing that end with the 'whoop' sound.
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What is the Pathophysiology of Pertussis?

  • Pertussis virus makes proteins which interrupt immune response.
  • Proteins anchor onto ciliated cells in the airway and kill them.
  • Mucus can't be moved out of the airway due to no cilia, so mucus builds up triggering a cough reflex.
  • The blood vessels near the area of infection become leaky to allow lymphocytes to arrive at the tissues.
  • Macrophages engulf the virus, but cannot destroy it due to toxins stopping the action.
  • Pertussis Toxin (PT) and Adenylate Cyclase Toxin (ACT) invade cells and disrupt their normal function.  Due to this, cells aren't activated (e.g. dendritic cells, t helper cells, IgE cells and mast cells).
  • PT and ACT cause extra holes in the blood vessels, causing fluid to leak out.  This causes the vessel to swell.
  • This causes air resistance which causes the 'whoop' sound with the cough.
  • Lymphocytes in the blood vessel multiply due to PT.  This is called lymphocytosis.
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What is the Catarrhal Stage (Pertussis)

  • Lasts 1-2 weeks.
  • Infection highly contagious
  • Infection in upper respiratory tract
  • Symptoms: runny nose, low-grade fever, mild cough
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What is the Paroxysmal Stage? (Pertussis)

  • Lasts 1-6 weeks.
  • Can last up to 10 weeks.
  • Worst stage of the infection.
  • Infection causes mucus to build up in the airways.
  • Symptoms: coughing fits followed by whoop sound, vomiting and exhaustion after coughing fits (paroxysms)
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What is the Convalescent Stage? (Pertussis)

  • Lasts 2-3 weeks
  • Children more susceptible to other respiratory infections.
  • Recovery gradual
  • Coughing fits lessen.
  • Damage to respiratory tract begins to heal.
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What are the Treatments for Pertussis?

  • Can be prevented with pertussis vaccine.
  • Usually part of the DTaP (diphtheria, tetanus and pertussis) vaccine.
  • Given to children at 2, 4, 5 and 15-18 months old.
  • Booster at 2-6 years old.
  • Some cases still occur (particularly in infants under 6 months)
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