pertussis


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Related to pertussis: Bordetella pertussis

pertussis

 [per-tus´is]

per·tus·sis

(per-tŭs'is),
An acute infectious inflammation of the larynx, trachea, and bronchi caused by Bordetella pertussis; characterized by recurrent bouts of spasmodic coughing that continues until the breath is exhausted, then ending in a noisy inspiratory stridor (the "whoop") caused by laryngeal spasm.
[L. per, very (intensive), + tussis, cough]

pertussis

/per·tus·sis/ (per-tus´is) whooping cough; an infectious disease caused by Bordetella pertussis, marked by catarrh of the respiratory tract and peculiar paroxysms of cough, ending in a prolonged crowing or whooping respiration.

pertussis

(pər-tŭs′ĭs)
per·tus′sal adj.

pertussis

[pərtus′is]
Etymology: L, per + tussis, cough
an acute, highly contagious respiratory disease characterized by paroxysmal coughing that ends in a loud whooping inspiration. It occurs primarily in infants and in children less than 4 years of age who have not been immunized. The causative organism, Bordetella pertussis, is a small, nonmotile gram-negative coccobacillus. A similar organism, B. parapertussis, causes a less severe form of the disease called parapertussis. Also called whooping cough.
observations Transmission occurs directly by contact or inhalation of infectious particles, usually spread by coughing and sneezing, and indirectly by contact with freshly contaminated articles. Diagnosis consists of positive identification of the organism in nasopharyngeal secretions. The initial stages of the disease are difficult to distinguish from bronchitis or influenza. A fluorescent antibody staining technique specific for B. pertussis provides an accurate means of early diagnosis. The incubation period averages 7 to 14 days, followed by 6 to 8 weeks of illness divided into three distinct stages: catarrhal, paroxysmal, and convalescent. Onset of the catarrhal stage is gradual, usually beginning with coryza, sneezing, a dry cough, a slight fever, listlessness, irritability, and anorexia. The cough becomes paroxysmal after 10 to 14 days; it occurs as a series of short rapid bursts during expiration followed by the characteristic whoop, caused by a spasm of the epiglottis, a hurried, deep inhalation that has a high-pitched crowing sound. There is usually no fever, and the respiratory rate between paroxysms is normal. During the paroxysm there is marked facial redness or cyanosis and vein distension, the eyes may bulge, the tongue may protrude, and the facial expression usually indicates severe anxiety and distress. Large amounts of a viscid mucus may be expelled during or after paroxysms, which occur from 4 to 5 times a day in mild cases and as many as 40 to 50 times a day in severe cases. Vomiting frequently occurs after the paroxysms as a result of gagging or choking on the mucus. In infants, choking may be more common than the characteristic whoop. This stage lasts from 4 to 6 weeks, with the attacks being most frequent and severe during the first 1 to 2 weeks, then gradually declining and disappearing. During the convalescent stage a simple persistent cough is usual. For a period of up to 2 years after the initial attack, paroxysmal coughing may accompany respiratory infections.
interventions Routine treatment consists of bed rest, adequate nutrition, and adequate amounts of fluid. Erythromycin or another antibacterial may be prescribed to reduce transmission or to control secondary infection. Hospitalization may be necessary for infants and children with severe or prolonged paroxysms and for those with dehydration or other complications. Oxygen may be needed to relieve dyspnea and cyanosis. IV therapy may be necessary when prolonged vomiting interferes with adequate nutrition. Intubation is rarely necessary but may be lifesaving in infants if the thick mucus cannot be easily suctioned from the air passages. Pertussis immune globulin is available, but its efficacy has not been established and its use is not recommended. Active immunization is recommended with pertussis vaccine, usually in combination with diphtheria and tetanus toxoids in a series of injections at 2, 4, and 6 months of age and boosters at 12 to 18 months and 4 years of age. One attack of the disease usually confers immunity, although some second, usually mild, episodes have occurred.
nursing considerations Severe paroxysms in an infant may require oxygen, suction, and intubation. The child needs to be kept calm and protected from respiratory irritants such as dirt, smoke, or dust. Overstimulation, noise, or excitement may precipitate paroxysms. Adequate nutrition and adequate fluids are encouraged through frequent small feedings. Common complications of the disease include bronchopneumonia; atelectasis; bronchiectasis; emphysema; otitis media; convulsions; hemorrhage, including subarachnoid and subconjunctival hemorrhage and epistaxis; weight loss; dehydration; hernia; prolapsed rectum; and asphyxia, especially in infants. Paroxysms can be fatal.

pertussis

Whooping cough Pediatrics An acute contagious and potentially epidemic bacterial infection caused by Bordetella pertussis–less commonly, B bronchoseptica and B parapertussis, which affects children < age 5; it causes 600,000 deaths/yr in the world Clinical Paroxysmal cough, post-tussive emesis, cyanosis, apnea, whoop Complications Pneumonia, atelectasis Diagnosis Culture, direct fluorescent antibody, lymphocytosis Management Supportive; infants may need hospitalization if coughing is severe Treatment Erythromycin, T-S Vaccine Whole cell–DPT vaccine

per·tus·sis

(pĕr-tŭs'is)
An acute infectious inflammation of the larynx, trachea, and bronchi caused by Bordetella pertussis; characterized by recurrent bouts of spasmodic coughing that continues until the breath is exhausted, then ends in a noisy inspiratory stridor (the "whoop") caused by laryngeal spasm.
Synonym(s): whooping cough.
[L. per, very (intensive), + tussis, cough]

pertussis

See WHOOPING COUGH.

per·tus·sis

(pĕr-tŭs'is)
Acute infectious inflammation of larynx, trachea, and bronchi caused by Bordetella pertussis.
Synonym(s): whooping cough.
[L. per, very (intensive), + tussis, cough]

pertussis (purtus´is),

n a disease caused by
B. pertussis in which the patient suffers from a cough that makes a “whooping” sound. Also called
whooping cough.
References in periodicals archive ?
Of these, all cases occurred in children 14 months to 14 years of age who had received a median of 5 doses of pertussis vaccine (range 2-5 doses) according to the current vaccination program (5 doses, administered at 2, 4, and 6 months and at 1.
This study was conducted to determine the incidence of confirmed pertussis cases within a cohort of children hospitalized for PLI.
In the United States, investigators at Northern California Kaiser Permanente have shown that the effectiveness of acellular pertussis in the Tdap vaccine wanes rapidly in adolescents.
During an outbreak of pertussis, Immunization Division staff collect specimens for testing, assess vaccine status, contact persons via phone who have been in places where exposure has occurred, and provide information for entities to share with those who may have been exposed.
Worldwide, there are an estimated 16 million cases of pertussis and about 195,000 deaths per year.
Maternal antibody transferred to the young infant has an antibody half-life that provides adequate protection during the first 2 months of life, when the infant is especially vulnerable to pertussis infection.
The decline was caused by public controversy about the safety of the pertussis vaccine, after some adverse effects were reported (CDC, MMWR, December 3, 1982.
According to study investigators, one explanation for the role that pertussis could potentially play in the pathophysiology of epilepsy may center on the occurrence of hypoxic brain damage resulting from severe pertussis-related coughing, "perhaps via increased intrathoracic and intra-abdominal pressure and central nervous system hemorrhages.
In Brazil, since the introduction of the pertussis vaccine in 1980, the number of reported cases fell sharply with a sustained downward trend.
Among hospitalized infants aged <12 months with complete information, 33% required intensive care; few (24%) had received any doses of diphtheria, tetanus, and acellular pertussis vaccine (DTaP) (Table 2).
pertussis were different between circulating isolates and vaccine strains used in the national vaccination programs.
In the study published late last month in the journal The Proceedings of the National Academy of Sciences, FDA researchers showed that acellular pertussis vaccines licensed by the FDA are effective in preventing the disease among those vaccinated.