Whooping cough is a respiratory illness caused by a bacterial infection. The disease is highly contagious among people. The bacterium that causes the disease stays in the throat, nose, and mouth of the infected person. The disease affects people across all ages, but it is more severe in kids who are less than a year. Older kids and adults are susceptible to whooping cough because the protection again the disease reduces with time. Infants get the disease from their caregivers, older sisters, brothers or parents who are not aware that they are infected, and the incubation period of the disease is between 7-21 days. Understanding critical aspects of whooping cough is essential in its control and prevention in the population.
Data on Whooping Cough
The infection is unique among the diseases that can be prevented through vaccination. The vaccination against the whooping cough does not provide long-lasting protection because it diminishes with time. The World Health Organization has strived to tackle the morbidity and mortality in infants and children resulting from whooping cough by ensuring that various governments have the necessary vaccinations. In 1999, data shows the global number of children under the age of five years that died of whooping cough was at 390,000 while the estimated number of pertussis cases was at 30 million. The introduction of two vaccine doses in 2014 led to the reduction of death cases resulting from whooping cough to be at 160,000 while the number of whooping cough cases was at 24 million (von Koenig, & Guiso, 2017). The reported published in 2015 by the World Health Organization showed that the global cases of whooping cough were estimated to be at 142,512 while the number of deaths was 89,000 (CDC, 2016). The statistics show a significant reduction in the number of deaths and cases relating to whooping cough. Countries that are developing have low vaccination coverage hence experiences children experience high disease rates. It is anticipated that the number of deaths in infants will drastically reduce in infants due to increased vaccine coverage.
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Causes of Whooping Cough
The disease is caused by a bacterium called Bordetella pertussis . Individuals are infected by inhaling the droplets that have been contaminated by an infected person either through sneeze or cough. The contaminated droplets produce toxins that affect the normal working of the respiratory tract to eliminate germs, the toxins produced by the bacteria inflames and destroy the lining of the breathing passages. Many infants are immunized against whooping cough but the immunity diminishes with time as one enters into early adulthood.
Symptoms of Whooping Cough
The symptoms of whooping cough take 21 days to begin after an unimmunized person is exposed to an infected person. Whooping cough is associated with a congested nasal, dry cough, mild fever, sneezing, running nose and red and watery eyes. Coughing that lasts for long makes infants turn blue from sound or to red from the effort. The production of the whooping sound makes a child to gasp air. Also, severity in coughing spells may make a person to vomit or experience difficulties in eating or drinking ( Gopal, Barber, & Toeg, 2019) . Severe coughing due to whooping cough leads to petechiae where the blood vessels rupture at the surface of the skin making the skin and whites of the eyes to bleed. Usually, the disease lasts for several weeks or takes a bit longer. The period is associated with cold symptoms that are followed by severe coughing.
Treatment of Whooping Cough
The fluids from the breathing passages are taken to the laboratory to examine whether a person whooping cough. The secretion samples from the nose and the throat are taken to assist in the examination of the Bordetella pertussis bacterium. Some tests like blood tests and carrying out of chest X-ray aid in the examination process of the disease. Antibiotics like erythromycin are used in the treatment of whooping cough. The medicines also help in stopping the spread of the bacterium from the infected people to other people. People in the household of the infected people can be given preventive antibiotics like prophylactic or vaccine boosters to stop the spread. Cough resulting from whooping cough makes a child vomit hence lose the nutrients that would help the child to recover the strength. The probability of vomiting can be reduced by giving a child frequent meals in small portions. A child is supposed to be encouraged to take more water, clear soup or fruit juice to help in preventing dehydration. Some illnesses are associated with whooping cough including seizures, ear infection, pneumonia or apnea. The thick respiratory secretions can be suctioned to clear the respiratory tract to allow a child to take extra oxygen. Further infections can be enhanced by isolating the child from others.
Prevention of Whooping Cough
The use of pertussis vaccine aids in preventing the disease. The vaccine used is called DTaP which refer to diphtheria, tetanus, accelular and pertussis ( Zhang et al., 2014) . The vaccine routinely is provided in five doses before a child celebrates the sixth birthday. DTP immunization has been integral in reducing the cases of whooping cough that take place annually hence saving lives. Individuals living in the same house with the person suffering from whooping cough are supposed to be given prophylactic oral antibiotics.
Effects of Whooping Cough
Whooping cough is a toxin-mediated illness that affects the breathing passage. The bacterium produces toxins that paralyze the cilia that assist in trapping and sweeping debris up and out of the breathing tract. Failure to trap the debris and other bodies causes inflammation of the respiratory tract hence impact the regular breathing. Whooping cough is associated with severe effects on people including dehydration, weight loss, and bladder incontinence.
Case Management of Whooping Cough
A case management of whooping cough starts with control of the infection to prevent further transmission. The caregivers and other individuals are required to be advised concerning the nature of the infection and the mode of transmission. More emphasis is supposed to be put on how to protect the exposure of the most vulnerable groups particularly infants. Exclusion is the second step where the infected children are excluded from schools or nurseries to prevent more infections as they receive the necessary antibiotic medications. Individuals who are in contact with the affected children are supposed to be avoided for five days since the commencement of the antibiotic therapy. The confirmed cases of people are recommended to be taken through antibiotic therapy as soon as possible to eradicate e the bacteria and limit more transmissions. Azithromycin and clarithromycin are considered as alternative agents particularly in cases a person fails to comply with therapy.
Additionally, individuals who have recovered from the illness and were unimmunized or partially immunized are required to complete the primary immunization and booster vaccine. Contact management of the confirmed or likely cases is necessary for ensuring that risk management is done effectively. The vaccination history and epidemiological factors of the affected people are put into consideration to make sure that risk assessment and contact management is done based on the laboratory testing. The people staying in the same household as the victim are considered close contacts. The vulnerable close contacts are the individuals are individuals who are at a higher risk of being infected or transmitting the disease.
Public health officers have the duty of handling special situations relating to whooping cough. The outbreak of cholera is one of the unique circumstances that need the intervention of public health officers to reduce the spread and number of fatal cases resulting from the disease. It has been established that health workers have emerged as the crucial source of transmitting whooping cough to patients, specifically children. Incidences of infected healthcare workers need immediate notification to public health. The whooping control team needs to carry out active surveillance among the exposed staff to prevent further transmissions. Cases of cholera in school settings or childcare require swift attention because this group is the most susceptible to whooping cough. The affected children are supposed to be excluded from others for five days and be kept on suitable antibiotic treatment. An incidence of the case of whooping cough in any school setting is supposed to be notified to parents through letters to keep be able to keep their children on a watch out. Cocooning is the best remedy for community outbreaks because it assists in preventing the spread of whooping cough to infants. Cocooning requires the immunization of the child care providers, health personnel, parents and siblings to mitigate the spread of the disease.
Effective management of the cases of whooping cough has been a challenge due to the absence of critical data. It is has been challenging to establish data on pertussis mortality from the presented secondary reports and statutory death certificates (Chow, Khandaker, & McIntyre, 2016). It is necessary for governments to develop mechanisms of recording deaths resulting from whooping cough to allow useful study and comparisons over various years.
In conclusion, whooping cough is a very contagious respiratory disease caused by a bacterium called Bordetella pertussis . The disease is more prevalent in infants as compared to adults. The illness can be prevented by the use of DTP vaccine in children that is executed in phases. Statistics indicate that the number of whooping cough cases and deaths has reduced drastically over the past 25 years due to the increase of vaccination coverage globally.
References
CDC. (2016). Pertussis | Whooping Cough | Cases in Other Countries | CDC. Retrieved from https://www.cdc.gov/pertussis/countries/index.html
Chow, M. Y. K., Khandaker, G., & McIntyre, P. (2016). Global childhood deaths from pertussis: a historical review. Clinical Infectious Diseases , 63 (suppl_4), S134-S141.
Gopal, D. P., Barber, J., & Toeg, D. (2019). Pertussis (whooping cough). bmj , 364 , l401.
von Koenig, C. W., & Guiso, N. (2017). Global burden of pertussis: signs of hope but need for accurate data. The Lancet Infectious Diseases , 17 (9), 889-890.
Zhang, L., Prietsch, S. O., Axelsson, I., & Halperin, S. A. (2014). Acellular vaccines for preventing whooping cough in children. Cochrane Database of Systematic Reviews , (9).
