Pertussis, with its distinctive cough, is a highly infectious disease. And while vaccination against it is part of South Africa’s childhood immunisation programme, it’s still “a significant cause of illness and hospitalisation”, according to a study in the August 2021 issue of Clinical Infectious Diseases.
This gives the incidence at 17 cases per 100 000 population, with the highest incidence in children under a year old. In the six years the study ran, out of the nearly 20 000 individuals enrolled, 10 with pertussis died – seven infants under six months old, and three immunocompromised adults.
What are the symptoms of pertussis?
The pertussis bacterium, Bordetella pertussis, is spread through sneezing and coughing, especially in the early stages of the disease, when most cases are not yet recognised, says the National Institute for Communicable Diseases (NICD).
Symptoms can vary from person to person. They start slowly, usually appearing seven to 10 days after exposure. At first they are similar to a common cold – a blocked or runny nose, mild dry cough and minimal or no fever.
Later the cough becomes more severe, erupting in paroxysms (attacks) with a high-pitched whoop, which may be followed by vomiting. The coughing fits can go on for one to two months.
Infants, on the other hand, may have only a slight cough or none, but their breathing can slow, even stop, cautions the NICD, causing their skin to turn blue. They are particularly at risk as their immune systems are immature, and infection can be life-threatening.
For them and for other children, complications of pertussis can include pneumonia, uncontrolled shaking and brain damage. For adolescents and adults, pertussis can bring loss of bladder control and a drop in weight.
How is pertussis diagnosed?
Your health professional can diagnose pertussis from symptoms and by laboratory testing, collecting a specimen from the back of your throat or through your nose, or getting you to cough into a bottle.
Treatment is often with antibiotics called ‘macrolides’, but antibiotics are not likely to change the course of your illness unless you take them near the onset, says the NICD.
Infants are usually hospitalised, and other children may be too, as they require intravenous fluids if they can’t keep down liquids or food.
Adolescents and adults can mostly be managed at home, with bed rest in a cool, dark room, plenty of liquids (water, juice, soups) and smaller meals given more frequently, to avoid vomiting them after coughing.
How can I prevent pertussis?
To protect your baby from pertussis in the first weeks of life, speak to your health professional about having a tetanus, diphtheria and pertussis booster shot in your second or third trimester of pregnancy, suggests Clicks pharmacist Waheed Abdurahman. A shot is also advisable for other close family members or caregivers, at least two weeks before they have contact with your baby.
When you are vaccinated in pregnancy, your body creates maternal antibodies which are transferred to your unborn baby, so both of you are protected.
In South Africa, the Expanded Programme on Immunisation schedule includes four doses of acellular pertussis vaccine. The first series is given in three doses at 6, 10 and 14 weeks of age. The fourth dose is a booster given at 18 months.
You can book your child's vaccinations at your nearest Clicks Clinic. Click here to find out more.
“However, immunity after vaccination is not lifelong and wanes over time,” says the NICD. “As a result, boosters are recommended after 4 to 8 years to ensure protective levels.”
IMAGE CREDIT: 123rf.com
* Reliance on any information provided on this Website is solely at your own risk.
The content of this Website is provided as a service to you for educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. If you are experiencing symptoms or need medical advice, you should seek the advice of your healthcare professional.