A review on Pertussis and pertussis like illnesses

Pertussis is a severe life-threatening respiratory infectious disease caused by the gram-negative Bordetella pertussis bacteria and is categorized into two typical and atypical types. Despite the relatively high coverage of the pertussis vaccine, the disease has reappeared periodically in recent years. In typical form, the patient has prolonged bronchiolitis along with lymphocytosis or whoop (long rasping indrawn breath). The atypical form usually occurs in younger infants and has no whoop and in these patients vomiting occurs following coughing. The severity of the disease ranges from mild to severe. Diagnosis in these patients is due to exposure to parents or adults with pertussis or chronic cough. The incubation period of the disease is 7-10 days ranging from 3 to 21 days, divided into three catarrhal, paroxysmal, and convalescent stages. Pertussis should be suspected in any person with prominent symptom or chief complaint of cough, especially in absence of fever, lethargy or muscle aches, exanthem or enanthem, sore throat, hoarseness, tachypnea, wheezing and rales. Infants under 3 months of age who are suspected of having pertussis are usually referred to hospital. Also, infants 3 to 6 months of age with severe paroxysms and other children with significant complications should be hospitalized. For the treatment, macrolides can be prescribed and Azithromycin is an optional in neonates. Until 5 days of treatment and 21 days if the patient is not treated, respiratory droplet isolation is necessary. Pertussis complications are common in younger infants, especially apnea. Although 3 first doses vaccination until 6 months of age is common in many countries, but booster doses varies in different countries based on the types of acellular vaccines.