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February 9, 2012

Pertussis (cont.)

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How is whooping cough transmitted?

Whooping cough is highly contagious and is spread among people by direct contact with fluids from the nose or mouth of infected people. People contaminate their hands with respiratory secretions from an infected person and then touch their own mouth or nose. In addition, small bacteria-containing droplets of mucus from the nose or lungs enter the air during coughing or sneezing. People can become infected by breathing in these drops.

Can adults get whooping cough?

Although whooping cough is considered to be an illness of childhood, adults may also develop the disease. The illness usually is milder in adults than in children, but the duration of the paroxysmal cough is just as long as in children. The characteristic whoop that occurs after paroxysmal bouts of coughing is recognized in only 20%-40% of adults with whooping cough.

Because immunity from the pertussis vaccine decreases over time but does not necessarily disappear, adults who do become infected may have retained a partial degree of immunity against the infection that results in a milder illness. Whooping cough in adults is more common than usually appreciated, accounting for up to 7% of adult illnesses that cause coughing each year. Infected adults are a reservoir (source) of infection for children, so it is particularly important that all family members and caregivers of young infants be properly vaccinated.

How is whooping cough diagnosed?

When a patient has the typical symptoms of whooping cough, the diagnosis can be made from the clinical history. However, the disease and its symptoms, including its severity, can vary among affected individuals. In cases in which the diagnosis is not certain or a doctor wants to confirm the diagnosis, laboratory tests can be carried out. Culture of the bacterium Bordetella pertussis from nasal secretions can establish the diagnosis. Another test that has been used to successfully identify the bacterium and diagnose whooping cough is the polymerase chain reaction (PCR) test that can identify genetic material from the bacterium in nasal secretions.


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