Pertussis is a highly communicable disease occurring mostly in children and adolescents and caused by the gram-negative bacterium Bordetella pertussis.
Pertussis is endemic throughout the world. Its incidence in the US cycles every 3 to 5 years. Pertussis occurs only in humans; there are no animal reservoirs.
Transmission is mainly via droplets of respiratory secretions that contain B. pertussis (a small, nonmotile, gram-negative coccobacillus) from infected patients, particularly during the catarrhal and early paroxysmal stages. The infection is highly contagious and causes disease in ≥ 80% of close contacts.
It takes about seven to 10 days for signs and symptoms to appear, though it can sometimes take longer.
- Runny nose
- Nasal congestion
- Red, watery eyes
The incubation period averages 7 to 14 days (maximum 3 weeks). B. pertussis invades respiratory mucosa, increasing the secretion of mucus, which is initially thin and later viscid and tenacious. Uncomplicated disease lasts about 6 to 10 weeks and consists of 3 stages:
The catarrhal stage begins insidiously, generally with sneezing, lacrimation, or other signs of coryza; anorexia; listlessness; and a troublesome, hacking nocturnal cough that gradually becomes diurnal. Hoarseness may occur.Fever is rare.
The paroxysmal stage begins with an increase in the severity and frequency of the cough. Repeated bouts of ≥ 5 rapidly consecutive forceful coughs occur during a single expiration and are followed by the whoop—a hurried, deep inspiration. Copious viscid mucus may be expelled or bubble from the nares during or after the paroxysms. Vomiting is characteristic.
The convalescent stage begins, usually within 4 weeks of onset. Average duration of illness is about 7 weeks (range 3 weeks to 3 months or more). Paroxysmal coughing may recur for months, usually induced in the still sensitive respiratory tract by irritation from an upper respiratory infection.
Nasopharyngeal cultures, direct fluorescent antibody testing, and polymerase chain reaction (PCR) testing
The catarrhal stage is often difficult to distinguish from bronchitis or influenza. Adenovirus infections and tuberculosis should also be considered.
white blood cell count is usually between 15,000 and 20,000/mcL (15 and 20 × 109/L).
Teens and adults often recover from whooping cough with no problems. When complications occur, they tend to be side effects of the strenuous coughing, such as:
- Bruised or cracked ribs
- Abdominal hernias
- Broken blood vessels in the skin or the whites of your eyes
Antim tart- A loose, rattling cough and the lungs feel full of mucus. The cough remains constant throughout the day and night. The patient faces excessive difficulty in raising the phlegm. Along with this, difficulty in breathing (most marked at night time) is present. Difficulty in breathing makes a person sit up from a prone position (in which it is worse). In addition to the above symptoms, a burning sensation in the chest may be present. Chest pain on coughing also arises in some of the cases. A cough that worsens after each meal.
Belladonna- Dry, as if glazed; angry-looking congestion (Ginseng); red, worse on right side. Tonsils enlarged; throat feels constricted; difficult deglutition; worse, liquids. Sensation of a lump. Œsophagus dry; feels contracted. Spasms in throat. Continual inclination to swallow. Scraping sensation. Muscles of deglutition very sensitive. Hypertrophy of mucous membrane.
Ipecac- A cough with difficult expectoration. The patient has a loose rattling cough with marked difficulty in expectoration. A constricted feeling in the chest and shortness of breath may arise. Suffocative spells may accompany the cough. Nausea and vomiting with a cough are also present in a majority of the cases.
Drosera- A dry, irritative (irritant) cough is the chief indicator. The cough comes in attacks that follow each other rapidly. A marked fatigue attends the coughing episodes. Other accompanying symptoms include tickling in the larynx, scraping sensation (like in a sore throat) and fetid breath with the cough.
Conium mac - Nocturnal cough. The patient has a cough at night on lying down. They are restless at night and tend to sit up many times due to coughing spells. A tickling sensation in the throat pit may be prominently present. A few individuals may complain of an unusually dry spot in the larynx.
Spongia tosta- A cough with extreme dryness of all the air passages. The cough is an exclusively dry, barking, hacking type. Chills may attend the cough. Warm drinks may offer a little relief. Along with this, shortness of breath and labored respiration may also be present.
Corallium rubrum - cough that results from PND (post nasal dripping). The cough appears in quick, short attacks that follow each other in quick succession. Along with the cough, excessive hawking is also present. Extreme exhaustion is felt along with the cough. A vital symptom that attends the above symptoms are extremely sensitive air passages to air (inhaled air feels cold).
Phosphorus and Hepar Sulph are beneficial medicines for cough in bronchitis. The characteristic indicators for using Phosphorus are cough with sputum expectoration of a purulent nature, frothy or blood-stained sputum. The phlegm may be salty or sweet to taste. Strong odours may trigger a cough. Along with cough, chest tightness, oppression of chest, and sharp stitching pain in the chest may be present. Heat/ burning sensation in the chest may also appear in a few individuals needing Phosphorus.
Hepar Sulph is significant medicine for bronchitis in older adults. The symptoms indicating use of Hepar Sulph are a loose rattling cough with thick, tenacious, yellow sputa. The cough may worsen from exposure to cold air, while warmth relieves it.