Pertussis, commonly known as whooping cough or chin cough is a highly contagious disease caused by the bacterium Bordetela pertussis. It can affect non-immunized individuals, but is predominantly a childhood disease that mostly occurs to children below 6 years. The mode of transmission is by direct contact with discharges from respiratory mucous membrane or by droplet. Incubation period of the disease is between 7-10 days. The disease is said to be highly communicable in the early catarrhal stage and before the paroxysmal cough stage.

Signs and Symptoms of Pertussis

Catarrhal Stage

Insidious onset, with irritating cough that gradually becomes paroxysmal (violent) and is followed by crowing or a high pitched whoop. The disease is highly contagious in this stage. Patient also manifests colds, fever, nocturnal coughing, tiredness, and listlessness.

Paroxysmal Stage

The client experiences violent, successive coughing. The client has 5-10 successive, forceful coughing which ends in a prolonged inspiratory phase or whoop. This could cause respiratory arrest in the client. The client’s eyes turn red and may seem to be bleeding.

Convalescent Stage

The signs and symptoms subsides and the client is on the road to recovery.

Diagnostic Exam for Pertussis

Nasal swab

A specimen is obtained by swabbing the Nares.

Nasopharyngeal culture

Is the confirmatory test for Pertussis.

Management of Pertussis

Antibiotic therapy

The client is given Erythromycin or Cotrimoxazole for 7-10days.

Pertussis immuneglobulin

These are globulins obtained from the plasma of people who have been immunized against pertussis and have already formed antibodies.

Fluid and electrolyte replacement

This loosens the secretions and allows it to be easily expelled.

Administration of Codeine

Codeine acts as an anti-tussive and gives a mild sedation.

Nursing Care for Clients with Pertussis

  • Provide adequate rest and conserve the energy of the patient. This decreases the oxygen demand and consumption of the client.
  • Maintain fluid and electrolyte balance
  • Maintain adequate nutrition with aspiration precaution
  • If the client experiences spasmodic cough place the client on Nothing per Orem (NPO) diet.
  • For Bottle-fed clients, the nipple should have small holes or use dropper.
  • Apply abdominal binder

Prevention of Pertussis

  • Provision of DPT vaccine in 3 doses, IM. Should be completed before the age of 6 months.
  • The first attack does not give permanent immunity but 2nd attacks are rare.
  • Proper disposal of nasopharyngeal secretions.
  • Covering of the nose and mouth when sneezing and coughing.
  • Never kiss the patient.