Pertussis

Pertussis is caused by Bordetella Pertussis, a Gram-negative, aerobic, egg-shaped bacterium (cocco-bacillus) first isolated in 1906.
The bacterium colonizes the epithelial cells of the lungs, where it prevents the proper functioning of cilia, which are responsible for removing debris in the lungs, resulting in the cough that is the main symptom of the disease. In addition, one of the toxins it produces weakens the immune system, making healing more complicated.

Pertussis is transmitted airborne, particularly by droplets (small particles emitted from the respiratory system during coughing, sneezing or even just talking). According to some studies, contact with droplets leads to infection in 90 percent of cases.

Despite the introduction of the vaccine in 1940, it is still a serious problem in developing countries. There are an estimated 16 million infections and 58,700 deaths each year.

Generally, the incubation period of pertussis is about 10 days.
Initially, the infection manifests itself in two stages with persistent and intense coughing, first catarrhal, for 1 to 2 weeks, and then becoming paroxysmal with respiratory crises, such as stages of apnea and cyanosis. Complications, especially in children, are due to bacterial overinfection that can cause otitis, pneumonia, and encephalitis. Infection mortality increases in children under one year of age.

Diagnosis is extremely easy in the paroxysmal phase, in which the features are obvious and make it identifiable with a normal examination. More difficult is identification during the early phase, in which symptoms are nonspecific. To aid in identification, a culture test on a swab taken in the nose and throat can be used to trace the presence of the bacterium.

Treatment depends on a number of factors, mainly age and severity of symptoms. In infants, hospitalization is necessary, with treatments such as fluid supplementation and mechanical ventilation, while in adults who have not yet reached the paroxysmal stage, antibiotics (erythromycin, clarithromycin, and azithromycin) may be used. In other cases, no specific treatment is provided.

The only effective tool for preventing the disease is vaccination, which has been mandatory in the child population since 2017. The vaccine is available in trivalent (tetanus, diphtheria, pertussis ), tetravalent ( tetanus, diphtheria, pertussis, polio ) or hexavalent (diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis and disease caused by Haemophilus influenzae type b) forms.