WHOOP WHOOP there it is!!! PERTUSSIS that is!!!



So What is Pertussis?

Have you ever wondered why you received a vaccination for something called Pertussis, more likely as a child, or even what Pertussis is?

Pertussis is a highly contagious respiratory disease that is caused by the bacterium Bordetella Pertussis.


In regards to vaccines, whether it was for yourself, or your child, you have probably heard of Pertussis, but in the form of an abbreviation, and in a combination with other vaccines known as DTaP, or Tdap, which are short for Pertussis, Diphtheria, and Tetanus.

These are a combination of vaccines against these particular infectious diseases.


Did you know you probably have also heard of Pertussis before, but by its more common “other name”, it is also known as “Whooping cough”.

Historically, Pertussis has been around for quite a while, but was first really noticed in the Middle Ages. The Bordetella Pertussis bacteria was only recently isolated about 110 years ago, and a vaccine was invented in 1914. The vaccine was eventually combined with the Diphtheria and Tetanus Vaccines in the 1940’s. These days, due to the waning effect of the vaccine, a booster may be needed for some people.



So what happens in Pertussis and how does Pertussis occur?


Pertussis, occurs from an infection by the Bordetella Pertussis bacterium.

These bacteria is very similar to the Diphtheria bacteria, but these attach to the cilia of the upper respiratory system within the lungs.

What are cilia you ask…and why does that matter?

Cilia are similar to tiny hairs, but these line the inside of respiratory tract, or lungs, that help move mucous and other foreign particles out of the lungs.

The Pertussis bacteria release poisonous toxins that damage the cilia, causing them to become immobilized, and ineffective. They also cause inflammation to occur, resulting in the swelling of the airways, resulting in airway obstruction.


What are Signs and Symptoms of Pertussis?


The symptoms of Pertussis generally begin about 5 to 10 days after someone has become infected. These symptoms include a low-grade fever, rhinitis or runny nose, and a mild cough. The cough begins slowly, but then develops into its signature WHOOPING COUGH.


This WHOOPING, or Whooping COUGH occurs after a coughing attack that is rapid and violent in appearance, occurs in rapid, repeated bouts, until all air is expelled from the lungs. As a struggle to inhale oxygen, a person makes a strong and loud whooping sound in an attempt to bring air in. In Adults, Pertussis usually begins looking like a Cold or Flu. In infants and babies, Pertussis does not always present as it does with adults, it can be the same cold or Flu-like symptoms but with the addition of Apnea, which are temporary pauses in breathing.

Unfortunately, some babies do not have a cough or a WHOOP, so it is not known that they have pertussis, but Pertussis can cause them to STOP BREATHING, and turn blue.

Most infants less than 1 years of age usually require hospitalization, due to how Pertussis affects their breathing, and pertussis is still a significant cause of death in this age group.




To make things worse, symptoms of pertussis sometimes do not develop for as long as 2 to 3 weeks. It is within these 2 weeks, after the coughing begins, that people are most contagious.

There are 3 general phases in Pertussis.

Stage 1- Catarrhal phase. This is the most infectious phase, and is when symptoms of runny nose, fever, sneezing, and mild cough

Stage 2- Paroxysmal phase. In this phase, coughing becomes more intense, the Whooping sound can begin, vomiting from continuous coughing may occur.

Stage 3- Convalescent phase. In the last phase, most symptoms have stopped, the patient is in a slow recovery phase, with a chronic cough, which may continue for weeks.


How is Pertussis diagnosed?

Pertussis is Diagnosed by performing a health history, assessing signs and symptoms, obtaining a mucous sample from in and through the nose, and assessing recent exposure to Pertussis.


How common is Pertussis?

An increase in Pertussis cases occur every couple of years, and outbreaks also do continue to occur. According to the CDC, In the United States, in as recent as 2012 there were almost 50,000 new cases. In 2018, there were more than 151, 000 cases of pertussis WorldWide.


How is Pertussis contracted or transmitted?


Pertussis is transmitted from person to person, and is a disease that is only found in humans.

Pertussis is transmitted via aerosolized respiratory droplets, like many other diseases, from coughing or sneezing, then it is inhaled.


TREATMENT

Treatment consists of the diphtheria, tetanus toxoids and acellular pertussis (DTaP) vaccine for prevention;and early antibiotic therapy for treatment and to minimize the spread, and shorten the amount of time someone is contagious. Even with the vaccine, a person can still contract Pertussis, however, the infection is generally more mild. This can help prevent people of all ages, especially babies, from getting really sick.


Unfortunately, for those who do contract Pertussis, after three weeks of having Pertussis, treatment will have little benefit as the bacteria have already wrecked havoc in your respiratory tract, damaging many cilia, leading up to the slow recovery phase, which can be for months, and who wants that!!!


Although Pertussis can occur, outbreaks could be more frequent, and with more cases of people becoming infected, and more sick. Combined with other existing diseases, such as Pneumonia, COPD, and asthma, can lead to worse outcomes.


The main reason things are not as they could be, meaning worse, and the reason Pertussis rarely occurs… IS BECAUSE we ARE vaccinated against it. Remember that when you hear about D “P” T, or TdaP, thats T—D—a--“P” with the “P” being PERTUSSIS, you now know what it means and what it is, and what it can do.


As a nurse or student nurse, If you were to encounter a patient with Pertussis, how would you care for them?

From a nursing perspective, in the assessment phase:

You will be assessing, and most importantly, and as a top priority, maintaining a patent airway.

In addition, nurses are going to assess and monitor the patient’s vital signs: temp, pulse, and blood pressure.

Most of the nursing focus will be on Auscultating for abnormal lung sounds; assessing and monitoring a patients’ respiratory status, including their work of breathing, Rate, depth, quality, pattern, use of accessory muscles, retractions, nasal flaring, and oxygen saturation.

Nursing interventions may include: administering antipyretics, oxygen, and antibiotics as ordered, encourage fluids and nutrition to promote healing.




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