Postinfectious Cough: B pertussis Infection and Cough
One type of postinfectious cough that is particularly virulent is that caused by B pertussis infection. Recommendations for this section of the review relating to Bordetella infection and cough were made using data obtained from a National Library of Medicine (PubMed) search dating back to 1950, which was performed in August 2004, of the literature published in the English language. The search was limited to human studies, using the search terms “cough,” “Bordetella pertussis,” “Pertussis infection,” and “whooping cough.”
B pertussis is a small pleomorphic Gram-negative coccobacillus that has been increasingly recognized as a cause of persistent cough in adolescents and adults. Because it leads to severe paroxysms of coughing with frequent complications, is highly contagious in children and adults, and responds to appropriate antibiotic coverage when administered early in the course of the disease, it is considered separately from other causes of postinfectious cough. The organisms are inhaled into the respiratory system by aerosol droplets, where they adhere to and invade the ciliated epithelial cells. Unlike other causes of postinfectious cough, pertussis infection or whooping cough can result in prolonged episodes of coughing. In fact, postinfectious cough has been nicknamed the hundred day cough.37 The organism is highly contagious as one active case can infect 70 to 100% of household contacts and 50 to 80% of school contacts. Source
The incidence of pertussis infection, or whooping cough, declined dramatically after the introduction of the whole-cell pertussis vaccine in the 1940s. Since the early 1980s, despite widespread vaccination, there has been an increase in incidence over all age groups, because complete immunization is not protective for all children, many children are incompletely immunized, and immunity wanes in most cases. The increase in incidence, however, has been particularly evident in adolescents and adults, with the greatest increase occurring in patients between the ages of 10 and 19 years. This likely occurs because immunity from immunization wanes in the decade that follows the most recent immunization and also because the number of adults who had immunity from natural infection in the prevaccine era is progressively decreasing.
Category: Respiratory Symptoms
Tags: Bordetella pertussis, pertussis infection, postinfectious cough, postviral cough