Pertussis

" Pertussis is very contagious and serious for infants, so it is very important to get the vaccination right".

DR. REYES LÓPEZ DE MESA
SPECIALIST. PEDIATRICS DEPARTMENT

Pertussis is an acute infectious-contagious disease affecting the respiratory system, the typical symptom of which is a cough in fits or paroxysms.

The contagion is made directly from the sick person to the healthy one through the air (when speaking, coughing...), by the drops of Pflugge. From the catarrhal period until four weeks after the beginning of the cough, if the sick person is not treated properly. Healthy carriers are not contagious.

Before the use of the vaccine, the age of greater incidence was between 2-5 years. Now it is more frequent in children under 1 year of age and has increased among adolescents and adults.

Immunity is not transmitted from the pregnant mother to her child.

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What are the symptoms of pertussis?

The following periods can be distinguished:

Incubation period: lasts between 1-2 weeks. It is asymptomatic.

Catarrhal period or onset: Lasts 2 weeks with non-specific catarrhal symptoms: rhinitis, sneezing, fever (if present), tearing, mild, dry and irritative cough, which becomes increasingly intense, predominantly nocturnal and may cause vomiting. The cough begins to be in accesses caused by the minimum stimulus.

Period of state, convulsive or asphyctic: it lasts about 4-6 weeks.

The cough becomes paroxysmal or convulsive in accesses or "fifths": the patient, feeling well, notices that he or she is going to have an access, takes a deep breath and begins with a cough that is hard to breathe, which makes it difficult for the child to stretch his or her face and chest forward, stick out his or her tongue, and becomes red, cyanotic and with watery eyes, and has a great feeling of anguish. When the crisis ends, a noisy inspiration appears (as the air passes through a very narrow pharynx) which is what is called the "rooster" of pertussis.

Do you have any of these symptoms?

You may have pertussis

What causes pertussis?

The usual cause of pertussis is a bacillus (a bacterium) of the genus Bordetella, called Bordetella Pertusis, which has a special appetite for the respiratory system. It produces immunity but this diminishes over time, so that the disease can return.

Other Bordetella such as parapertussis, bronchioseptica and other agents such as Mycoplasmas or viruses, can cause prolonged coughing, but none of them is a major cause of pertussis.

What is your prognosis?

The most serious and frequent complications that can cause death in infants and young children are

  • Respiratory: bronchitis, pneumonia...
  • Neurological: tosferinous encephalopathy (convulsions, alterations of consciousness...) due to lack of oxygen and hemorrhages due to increased venous pressure.

How is pertussis diagnosed?

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The diagnosis is made:

1. Fundamentally by the clinic (difficult in the catarrhal period).

2. Search for Bordetella Pertusis in pharyngeal secretions, which serves to differentiate them from other diseases with irritative, intense and repeated cough (laryngitis, tracheitis, tuberculosis, cystic fibrosis...) and the presence of foreign bodies aspirated into the respiratory tract.

How is pertussis treated?

Treatment should always be initiated by the physician or pediatrician.

  • Hospitalization: especially infants and young children or those with complications.
  • Feeding: small and numerous feedings if vomiting is frequent. Intravenous fluids.
  • Sedation: in some cases it is necessary.
  • Expectorants and Antitussives: Should not be used.
  • Antibiotics: useful especially if administered early and at appropriate doses. Erythromycin is the one of choice, although others can be used.

Passive prophylaxis:

  • Administration of hyperimmune gamma globulin As soon as possible after infection. Especially in newborns and infants. Its usefulness is doubtful.
  • Administration of the antibiotic Erythromycin for 10 days (prevents the bacillus from colonizing the pharynx or if this has been eliminated).

Active prophylaxis:

  • DTaP vaccine administered together with diphtheria and tetanus vaccine, in three doses (2, 4, 6 months) and with booster doses at 15-18 months and 6 years.
  • At 13-16 years with adult dtpa triple virus (low antigenic load) Administer one dose every 10 years in order to maintain immunity in adults.

Where do we treat it?

IN NAVARRA AND MADRID

The Department of Pediatrics
of the Clínica Universidad de Navarra

All our specialists work exclusively and, in addition, since we have all the technology in the same center, we offer the performance of tests and diagnosis in less than 72 hours.

We have a team of highly qualified professionals to attend the different specialized units: Oncopediatrics, Neuropediatrics, Endocrinopediatrics, Neonatology, etc.

Organized in specialized units

  • Neonatology Area.
  • Pediatric Endocrinology.
  • Pediatric Cardiology.
  • Pediatric Neuropediatrics.
  • Digestive and pediatric nutrition.
  • General and preventive pediatrics.
  • Pediatric Pneumology.
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Why at the Clinica?

  • Comprehensive care of the child.
  • Professionals who are experts in the different areas for a better diagnosis and treatment.
  • Equipped with the latest technology for newborn care.

Our team of professionals

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