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Pertussis

An extremely contagious infectious disease, also known as whooping cough.  It mostly affects infants and young children and is most hazardous in new born babies.  The main features are bouts of coughing, followed by a “whoop” as air is drawn back into the lungs.

Cause

The main cause is infection with BORDETELLA PERTUSSIS bacteria, which are spread in airborne droplets.  In wealthy countries such as the UK, however, the incidence of pertussis has been heavily reduced by immunisation.

 

Symptoms

After an incubation period of about 7-10 days, the illness begins with a mild cough, nasal discharge, fever, sneezing and sore eyes.  After several days, the cough becomes worse.  Whooping occurs in most cases.  Sometimes the cough can cause vomiting.  In infants, there is a risk of temporary apnoea (cessation of breathing) following a coughing spasm.  The illness can last anything from a few weeks up to three months, although the child is often only infectious for roughly three weeks.

Complications

Coughing can cause nose bleeds and bleeding from ruptured blood vessels on the surface of the eyes or petechiae (red, flat, pinhead spots) on the face.  Other possible complications include dehydration from constant vomiting; pneumonia; pneumothorax (a form of collapsed lung); bronchiectasis (permanent widening of the airwaves); and seizures.  Left untreated, pertussis can be fatal.

Diagnosis

Pertussis is generally diagnosed from its symptoms.  In the initial stages of the illness, the antibiotic erythromycim is usually given to reduce the child’s infectivity.  Treatment involves keeping the child warm, having plenty to drink, giving small, frequent meals and protecting him or her from stimuli, such as smoke, that can provoke coughing.  If the child becomes blue or persistently vomits after coughing, he or she must be taken to hospital.

Prevention

In the UK, vaccination against pertussis is often given at 2, 3 and 4 months of age, with a booster dose at between 3 years 4 months and 5 years of age.

Possible complications of vaccination include fretfulness and mild fever.  Hardly ever, an infant can react severely, with seizures or high pitched screaming.

Communities need to maintain a high level of immunity, through immunisation, to protect infants.  It should be remembered that the risks from the disease itself are far worse than any risk from the pertussis vaccine.  


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