Recognising, Assessing, Managing, And Preventing Whooping Cough

The aim of this article is to highlight strategies to recognise, assess, manage and prevent whooping cough. After reading this article and completing the time out activities you should be able to:
Describe the aetiology and epidemiology of whooping cough.
Identify individuals at increased risk of developing whooping cough and associated complications.
Discuss the identification, assessment and management of individuals with whooping cough.
Outline the role of vaccination in the prevention of whooping cough.

Whooping cough, also known as pertussis, is an acute and highly contagious disease of the upper respiratory tract caused by Bordetella pertussis (Zhang et al 2012). Classic pertussis is characterised by paroxysms of coughing,
inspiratory whoop and post-tussive vomiting (Teng and Wang 2012). Pertussis means violent cough (Ministry of Health 2011) and was known as ‘the cough of 100 days’, emphasising its prolonged nature (Teng and Wang 2012).

Causes of Whooping Cough

Pertussis, also known as whooping cough is a highly contagious bacterial infect caused by a bacterium known as Bordatellapertussis, (Hegerle & Guiso 2013).  Whooping cough causes a series of severe coughing attacks to the infected individual. These attacks if severe can cause broken ribs, lack of oxygen, losing consciousness and vomiting, (Carson-Dewitt  & Mertz 2015)

Whooping cough was first experienced in the 16^th century but it was till in the early 20^th century Bordatellapertussis was identified as its cause. (Carson-Dewitt  & Mertz 2015).

 People of all ages are at risk of contracting the disease but newly born infants who have not received vaccinations on whooping cough are at a higher risk of contracting the disease. Pertussis can be transmitted from one person to another through contact of body fluids from the infected person as they cough to the second party. Reports have shown an 86% estimated worldwide coverage on DTP3 vaccine with at least one child in 10 children did not receive even the first dose of DTP1 (WHO report 2018). Despite the recent developments in the health sector, Pertussis still remains one of the poorly controlled vaccine preventable diseases. There is an estimated 16million cases globally every year with about 190,000 deaths every year worldwide.  

This reports gives an overview of the causes of whooping cough, how it is prevented and the risk factors associated with whooping cough.

There has been developments concerning Pertussis over the past years. Since the 1980s, the number of cases reported of gradually reduced until in 2012, when the number of reported cases shot up and the highest number of cases ever reported of 48,277 cases in the US only. That number however reduced in 2013 but rose again in 2014. In the developing countries, there is a higher number of cases of whooping cough. This literature review explores the causes/risk factors associated with whooping cough, symptoms and preventive measures. (Batten,  Schummer  & Selden 2017)

According to (Reimann et al 2016), the main risk factors of whooping cough are immunization history, contact with someone who is probably infected and contact with high-risk individual.

Lack of immunization is the major cause of one contracting Pertussis. The immunization history of the specific individual determines the risk of them contracting whooping cough. Individuals who are more than one years old and have stayed more than 12 years since their last immunization, they are at risk of being infected with the bacteria. Infants who are less than one year old are a higher risk of contracting whooping cough. The infants must be at least 6 weeks old before they can receive their first dosage of DTP1 vaccination against whooping cough.

Therefore, if the kid did not receive antibodies to protect them from whooping cough before they were born, they might be a higher risk of being infected with whooping cough, (O'brien et al 2018). After the first vaccination, the infant should receive 2 more DTP vaccinations to make them completely safe against whooping cough. Some infants are unable to receive these vaccinations due to their location especially in the low income and middle-lower income countries who are in remote areas and medical practitioners have no access to them. Also, some parents refuse to have their children immunized due to their religious beliefs and others due to lack of awareness on whooping cough.

Risk Factors Associated with Whooping Cough

Children are at risk of contracting whooping cough due to interaction with cases suspected to have pertussis. These cases can be from parents or caretakers who have no knowledge that they are infected. Such a person is capable of infect 12-15 other people, (Bakalar 2015). High-risk individuals are individuals who have not been immunized against whooping cough and have likely been in contact with an infected person.

In the book, encyclopedia of medicine, (Carson-Dewitt & Mertz 2015), explained the various symptoms of whooping cough and the stages the symptoms appear in. Whooping cough can go undetected 7-14 days after infection. The symptoms starts showing after 14 days and are in stages. These stages are; Incubation (asymptomatic), Catarrhal, spasm, and recuperation. The asymptomatic period is a period of 7-14 days after infection with the bacteria. During this period, there are no visible symptoms, (Bentley, Pinfield & Rouse 2013).

The bacteria multiply and enter the respiratory tract tissues. The second stage is catarrhal and is accompanied by severe symptoms. This is usually 7-14 days after infection and some of the symptoms are usually rhinorrhea, frequent sneezing, tearing, and fatigue, loss of appetite, fever and mild coughs. This is the stage where it starts being contagious. The next stage is the spasm/ attacks stage. In this stage, the patient starts experiencing severe coughing attacks which are uncontrollable. These coughs empty the lungs therefore a whooping sound when inhaling afterwards. At this stage, infants have breathing problems and apnea and pneumonia is common in this stage.

For this report, secondary data from the provided resources was used and additional data from previous scholar studies on whooping cough.

The various causes, symptoms and stages were identified. Also, it was realized that the main problems leading to whooping cough was lack of knowledge on whooping cough, Abandonment by some parents, Failure to report Pertussis cases and lack of proper surveillance on Pertussis, (Bakalar 2015).

Despite the developments in the health sector, whooping cough still remains an issue. If the correct measures are taken, whooping cough can be totally eradicated.  From the study, the main causes of whooping cough are lack of immunization, the duration since the last immunization, incomplete immunization dosage, and contact with the fluids from sneezing or coughing from an infected individual. Studies show that most children get whooping cough from the people they come in contact with and thus ensuring that the people who come in contact with the baby are immunized against whooping cough. Because babies under 2 months cannot be immunized against whooping cough, mothers are advised to have a Dtap vaccination during the third trimester of the pregnancy, (Carson-Dewitt & Mertz 2015).

As seen all through India, Whooping cough is more pronounced that even Australia. Most of the people who reside from India are more prone to Whooping cough that Australia. Its is rated that 30% of Indian population have whooping cough at ago which is a very large number as compares to Australia which is at 23%. This is mainly caused by the large population in India than Australia hence the disease can spread very fast in India than Australia, (Batten,   Schummer  & Selden 2017)..

Symptoms and Stages of Whooping Cough

However, many deaths due to whooping cough are still registered yearly in Australia. These deaths however can be reduced through vaccination of at least 3 doses of DTP and a preferred complete dose of 5 shots, for the Indigenous people and for the non-indigenous people, this so in fact so severe since they are not conversant with the conditions and the environment. . Adults interacting with children are advised to be vaccinated against whooping cough to reduce their chances of being infected and infecting the children. Complications of whooping cough include bacterial infections such as dehydration, pneumonia, broken blood vessels in the eyes, nose, and brain, broken ribs and seizures due to lack of oxygen and sometimes deaths (Batten,   Schummer  & Selden 2017).

Whooping cough is a condition that can cause immense loss and severe complications and thus needs to be prevented and if one infected, cured, In India, Whooping can be prevented by making sure that all those people with whooping cough cover their nose and mouth while coughing in order to prevent its spread, this is because India is largely populated hence the spread of diseases is very fast. But in Australia, this can be done through vaccinations and treatment using antibiotics. Also if controlled properly, whooping cough can cease to be an issue, (Bakalar 2015)..

Conclusion

Whooping cough is mostly common in infants and most of the cases are not reported. However, it can be totally eradicated if the public is educated on whooping cough and resources allocated to reach the remote areas. Whooping cough can be prevented through vaccination of the three doses of Diphtheria-Tetanus-Pertussis (DTP3). New born infants can be protected by ensuring that the individuals that they come in contact with are completely safe of the infection.

References

Carson-Dewitt,R., & Mertz,L.(2015). Whooping Cough. In J.L. Longe (Ed.), The Gale Encyclopedia of Medicine (5 th ed., Vol. 8,pp. 5426-5430). Farmington Hills, MI: Gale . Retrieved from

https://link.galegroup.com.ezproxy2.acu.edu.au/apps/doc/cx3623301990/GVRL?u=acuni&sid=GVR&xid=8b02a5ac

Batten, D.  Schummer, P.  &Selden, H. (2017). Whooping Cough (Pertussis), Human Diseases and Conditions (3rd ed., Vol. 4, pp. 2152-2156).Farmington Hills, MI: Charles Scribner's Sons. Retrieved from https://link.galegroup.com.ezproxy1.acu.edu.au/apps/doc/CX3630000470/GVRL?u=acuni&sid=GVRL&xid=1918c072

Hegerle, N., & Guiso, N. (2013). Epidemiology of whooping cough & typing of bordetellapertussis. Future Microbiology, 8(11), 1391-1403. Retrieved from

https://search-proquest-com.ezproxy1.acu.edu.au/docview/1668264977?accountid=8194

Bentley, J., Pinfield, J., & Rouse, J. (2013). Whooping cough: Identification, assessment and Management. Nursing Standard (through 2013), 28(11), 50. doi:https://dx.doi.org.ezproxy1.acu.edu.au/10.7748/ns2013.11.28.11.50.e7911

Bakalar, N. (2015) “Symptom-Free Carriers May Be Spreading Whooping Cough.” Well (blog), New York Times, Retrieved from: https://well.blogs.nytimes.com/2015/06/29/symptom-free-carriers-may-be-spreading-whooping-cough/

O'brien, D. P., Cannella, S. E., Durand, D., Eenguene, V. Y. N., Hernandez, B., Ghomi, M., ... & Vachette, P. (2018). Calcium tightly regulates disorder-to-order transitions involved in the secretion, folding and functions of the cyaA toxin of Bordetella pertussis, the causative agent of whooping cough. Toxicon, 149, 92.

Reimann, K. A., Belli, A. J., Fulco, S., Warfel, J. M., Wang, R., Cavacini, L., ... & Klempner, M. S. (2016). Immune features that afford protection from clinical disease versus sterilizing immunity to Bordetella pertussis infection in a nonhuman primate model of whooping cough.

World Health Organization.(2018) Ave. Appia 20, 1211 Geneva 27,  Switzerland. Telephone: 41 22 791 21 11. Website: https://www. who.int/en/