Whooping cough is a highly communicable acute bacterial disease of childhood caused by Bordetella pertussis.

The use of DPT vaccine has reduced the prevalence of whooping cough in different populations.

• Has strong tropism for the brush border of the bronchial epithelium.
• The organisms proliferate here and stimulate the bronchial epithelium to produce abundant tenacious mucus.
• Within 7-10 days after exposure, catarrhal stage begins which is the most infectious stage.
• According to the Centers for Disease Control and Prevention (CDC)Trusted Source, before a vaccine was available, whooping cough was a major cause of childhood deaths in the United States.
• The condition is selflimiting but may cause death due to asphyxia in infants.
• B.pertussis produces a heat-labile toxin, a heat-stable endotoxin, and a lymphocytosis-producing factor called histaminesensitising factor

SYMTOMS

• Low grade fever
• Rhinorrhoea,
• Conjunctivitis
• Excess tear production.
• Paroxysms of cough occur with characteristic ‘whoop’.

After a week or two, signs and symptoms worsen. Thick mucus accumulates inside your airways, causing uncontrollable coughing. Severe and prolonged coughing attacks may:

• Provoke vomiting
• Result in a red or blue face
• Cause extreme fatigue
• End with a high-pitched “whoop” sound during the next breath of air.

MICROSCOPICALLY FEATURES

• The lesions in the respiratory tract consist of necrotic bronchial epithelium covered by thick mucopurulent exudate.
• In severe cases, there is mucosal erosion and hyperaemia. The peripheral blood shows marked lymphocytosis upto 90%
• Enlargement of lymphoid follicles in the bronchial mucosa and peribronchial lymph nodes.

COMPLICATIONS

• Bruised or cracked ribs
• Abdominal hernias
• Pneumonia
• Difficulty in sleep
• Broken blood vessels in the skin or the whites of your eyes

Infants with whooping cough require close monitoring to avoid potentially dangerous complications due to lack of oxygen. Serious complications include:

• Brain damage
• Pneumonia
• Seizures
• Bleeding in the brain
• Apnea (slowed or stopped breathing)
• Convulsions (uncontrollable, rapid shaking)
• Death

PREVENTION

Children should receive five injections of the DTP vaccine, according to the following recommended vaccination schedule:

• First dose: 2 months old.
• Second dose: 4 months old.
• Third dose: 6 months old.

Booster dose at

• Fourth dose: Between 15 and 18 months old.
• Fifth dose: Between 4 and 6 years old.