Whooping Cough Pertussis

Organism Bordetella pertussis. B. parapertussis produces a milder disease.

Clinical features Illness commences with upper respiratory symptoms, fever and cough, which becomes paroxysmal with the characteristic whoop, or sometimes ends in vomiting. The classic 'whooping' disease is not seen in children under 3 months of age, when instead, they have attacks of cyanosis and stop breathing. Whooping cough is a serious disease if it occurs at a young age, the severity being inversely proportional to age. A mild infection in the older child, it becomes an important cause of death in the very young.

Diagnosis is mainly on clinical criteria, but culture of the organism from a nose or throat swab can be attempted, although the organism is difficult to grow. Serology is useful.

Transmission is via airborne spread of droplets particularly during the early stage of illness. Older children and adults may have such a mild infection that their importance as a source of infection is not realized. Vaccinated individuals can have subclinical infection in which organisms are disseminated.

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