Whooping Cough (Pertussis): A Medical Overview, Pathology And Clinical Manifestations

Funom Makama By Funom Makama, 1st Apr 2014 | Follow this author | RSS Feed
Posted in Wikinut>Health>General Health>Diseases & Infections

Pertussis, which means intensive cough is an acute respiratory infection, seen more commonly in young children. The disease is also more serious in them. The term “whooping cough” is derived from the occurrence of progressive repetitive paroxysms of cough followed by inspiratory whoop.

An Overview Of Pertusis

Pertussis is caused by Bordetella pertussis which is highly infective. Bordetella parapertussis and B. bronchiseptica are members of the same genus, rarely causing disease in man. Maximum incidence is seen in children below five years and the mortality is highest for children below 1 year of age. The organisms are spread by droplet infection and the route of entry is the respiratory tract.

Pathology: The mucosal lining of the respiratory tract shows inflammation. Peribronchial lymphoid hyperplasia occurs initially and this if followed by necrosis of the midzonal and basilar layers of the bronchial epithelium. This leads to the accumulation of tenacious mucus, atelectasis and eventually bronchiectasis.

Clinical Manifestations Of Whooping Cough

The incubation period is usually 7 to 14 days but may be prolonged to 20 days. Three stages can be distinguished- catarrhal, paroxysmal and convalescent: each lasting up to 2 weeks so that the course of the disease extends to 6 to 8 weeks.

The catarrhal stage manifests with rhinorrhea, mild fever and cough. During this stage, clinical recognition of the disease is difficult. This is the most infective stage.

In the paroxysmal stage, cough starts, increases in severity, and becomes repetitive and explosive. Each paroxysm is followed by a whoop produced by a suddent massive inspiratory effort through a narrowed glottis. During this paroxysm of cough, the infant develops facial congestion, distention of neck and scalp veins, lacrimation, cyanosis and clouding of consciousness. The paroxysm ends with the onset of vomiting. The whoop may not be distinctly made out in younger infants, but they may become asphyxiated and develop anoxic convulsions. Physical examination may reveal periorbital edema. In the uncomplicated cases, lung signs are usually absent.

Convalescence is marked by the decrease in frequency and severity of the paroxysms. Vomiting subsides and the patient’s appetite improves. At this stage, the child is very susceptible to develop super-infections by other respiratory pathogens and this may lead to recurrence of the paroxysmal of cough. When this occurs, it may last for several months.

For more Health Articles, visit the following links:
1. Fitness And Exercise From A Doctor’s Perspective: Maintaining The Lifestyle
2. Special Types Of Anemia: Sideroblastic Anemias And Paroxysmal Nocturnal Hemoglobinuria (PNH)
3. Diphtheria: The Health Significance Of Its Clinical Diagnosis And Phases Of Treatment

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