Perta, also known as pertussis or whooping cough, is a highly contagious respiratory illness causing severe coughing fits. It poses a serious health threat, particularly for infants and young children.
Understanding Perta (Pertussis)
Perta is a respiratory infection caused by the bacterium Bordetella pertussis. This bacterium attaches to cilia, tiny hair-like structures lining the upper respiratory system. It releases toxins that damage these cells, leading to inflammation and swelling in the airways and making breathing difficult. The infection is highly contagious and results in prolonged, severe coughing spells.
The bacteria multiply in the nasopharynx and can extend to the bronchi and bronchioles. This damage contributes to the characteristic symptoms of whooping cough. While anyone can contract perta, its impact is significant in infants and young children due to their developing respiratory systems.
Symptoms and Stages of Perta
Perta progresses through three distinct stages, each with characteristic symptoms. The catarrhal stage, lasting one to two weeks, resembles a common cold. Individuals may experience a runny nose, low-grade fever, mild cough, and sneezing. This stage is when the infection is most contagious, even with mild symptoms.
The paroxysmal stage follows, characterized by severe, uncontrolled coughing fits. These intense bouts, known as paroxysms, can lead to difficulty breathing, vomiting, and exhaustion. The distinctive “whooping” sound occurs as a person gasps for air after a coughing spell, though not everyone, especially infants and adults, will make this sound. This stage can last for weeks or months.
The final stage is the convalescent stage, marking gradual recovery. The frequency and severity of coughing fits slowly decrease. While the cough lessens, it can persist for weeks or months, and may sometimes return with subsequent respiratory infections.
Transmission and Risk Factors
Perta spreads easily through respiratory droplets released when an infected individual coughs or sneezes. These droplets can be inhaled by those nearby, leading to new infections. Transmission also occurs through close, prolonged contact or by sharing breathing spaces. An infected person can transmit the illness from the onset of cold-like symptoms until about three weeks after coughing fits begin.
Several factors increase the risk of contracting perta or experiencing severe outcomes. Infants under 12 months old who are unvaccinated or not fully vaccinated are at the highest risk for serious illness and complications. Protection from childhood vaccination can wane, making teenagers and adults vulnerable to infection and capable of spreading it.
Risk factors include close contact with an infected person, epidemic exposure, and crowded environments like schools or hospitals. Adults with conditions such as asthma or weakened immune systems also face increased risk.
Diagnosis and Treatment
Diagnosing perta can be challenging early on due to symptoms resembling a common cold. Healthcare professionals consider a physical examination and patient symptoms. Laboratory tests confirm the diagnosis, using methods like a nasopharyngeal swab or aspirate to detect Bordetella pertussis bacteria. Polymerase Chain Reaction (PCR) tests are used for their speed and sensitivity, detecting bacterial DNA. Bacterial cultures are also used and are considered the gold standard for diagnosis, though they take longer to yield results.
Treatment for perta primarily involves antibiotics, particularly macrolides such as azithromycin, clarithromycin, or erythromycin. Early antibiotic therapy, ideally within the first three weeks of cough onset, can reduce symptom severity and duration. Antibiotics also shorten the period an infected person is contagious, helping prevent further spread. Supportive care is also important, including adequate hydration, rest, and managing severe coughing. In severe cases, especially for infants, hospitalization may be necessary to monitor breathing and provide additional support.
Prevention of Perta
Vaccination is the most effective way to prevent perta and its spread. For infants and young children, the DTaP vaccine (Diphtheria, Tetanus, and acellular Pertussis) is recommended. This vaccine is administered in a series of doses: typically at 2, 4, 6, 15-18 months, and a booster between 4 and 6 years of age.
For adolescents and adults, the Tdap vaccine (Tetanus, Diphtheria, and acellular Pertussis) is recommended. Adolescents typically receive a single dose around 11 to 12 years of age. Adults who have not previously received Tdap should get one dose. Pregnant women are advised to receive a single dose of Tdap during each pregnancy, preferably between 27 and 36 weeks of gestation. This vaccination helps pass protective antibodies to the newborn, offering protection until the baby is old enough for their own vaccinations.
The “cocooning” strategy involves vaccinating family members and close contacts of a newborn. This creates a “cocoon” of protection around infants too young to be fully vaccinated. General hygiene practices, such as frequent handwashing and covering coughs and sneezes, also reduce the spread of respiratory infections.
When to Seek Medical Attention
Seek medical attention if perta is suspected, especially for infants and young children. If an individual, particularly a baby, experiences difficulty breathing, struggles to take a breath, or has pauses in breathing, seek immediate medical help. Signs such as the skin, lips, or face turning blue or purple (cyanosis) during coughing spells indicate a lack of oxygen and require urgent care.
Severe and persistent vomiting after coughing, signs of dehydration, or seizures are also serious warning signs. Anyone experiencing a severe, worsening cough, or a distinctive “whooping” sound, particularly if exposed to someone with perta, should consult a healthcare professional. For infants under six months with any perta symptoms, medical evaluation should happen without delay.