The development of the symptoms and signs of Pertussis depend on various factors such as age of the individual, exposure to previous infections, immunization status, etc. The period between which the organism enters the host and the development of the first symptoms (incubation period) varies between 6 to 20 days. Usually, the symptoms and signs appear within seven to ten days (NHS. 2007). The classic type of Pertussis infection develops in child who has not been immunized, usually between the ages of one to ten years.
The condition runs for about 6 to 8 weeks, and can be broken down into 3 stages, namely catarrhal, paroxysmal and convalescent stages. During the early stages of the disease, several symptoms such as increase in the lacrimation, running nose, cough, increased salivation, etc develop. Over a period of one to two days, the symptoms tend to worsen. The cough slowly becomes more serious in nature. During a single expiration, the individual releases about five to ten coughs. This is followed by the characteristic whoop during the inspiration in which the individual tends to breathe in large amounts of air, even when the glottis may be contracted.
The child may vomit after a coughing episode. During this stage, the individual appears cyanosed, has a red face and bulging eyes, excessive lacrimation, excessive salivation, and the veins present in the neck appear distended. These episodes of cough are know as paroxysm, and can develop several times in a day. The child may lose a lot of weight as these episodes tend to cause tiredness, exhaustion, malaise and loss of huge amounts of energy. Several factors can trigger attacks of cough such as sneezing, exercise, yawning, etc (James D.
Cherry. 1998, pp. 1429). The cough usually worsens at night times. The cough is usually dry in nature and does not bring about sputum. During the later stages of paroxysms stage, the child brings out thick sputum following the cough episodes. During the cough episodes, the blood vessels present in the respiratory tract and the eyes may get ruptured leading to petechiae and bleeding (Mayo Clinic. 2006). Some children with whooping cough, may have a more persistent or chronic version of the disease.
The cough may persist even after a two month period causing difficulty in sleeping and other symptoms. The symptoms may be atypical in children especially if they are immunized against Pertussis (Anthony Harnden. 2006). The ribs could also get fractured as a complication to the severe cough episodes. During the paroxysmal stage, the child can spread the infection to others, and hence, should be isolated from other children. Following administration of antimicrobial agents, the child may be infectious for about 5 days (NHS. 2007).
During the third stage of the disease (that is convalescent stage), the severity of the symptoms and signs reduces. Pertussis usually does not cause fever, although this may develop due to a secondary infection. In the convalescent stage, the whoop, cough and vomiting becomes less severe, and the episode usually lasts for about one or two weeks (James D. Cherry. 1998, pp. 1429). Infants may experience a particularly severe form of Pertussis infection. The condition may be so serious that the baby may require hospitalization or admission to the intensive care unit.
Some of the common complications that can develop in infants include pneumonia, seizures, encephalopathy, and even fatal outcomes. The infant mortality rate of Pertussis infection is about 1. 3 %. The white blood cells are very much increased in numbers and the seizures may be associated with apnea. Babies usually do not develop the characteristic whoop. The symptoms and signs of Pertussis may be atypical in adults. Usually adults that are un-immunized or not properly immunized develop the condition. Most of the individuals experienced bout of severe cough along with the whoop (James D.
Cherry. 1998, pp. 1430). In others, the cough may be dry in nature without the characteristic whoop, resembling bronchitis (Mayo Clinic. 2006). However, the condition tends to be misdiagnosed in adults. Usually it may be diagnosed as upper respiratory tract infection, bronchitis, etc. In Germany, the adult has a more typical form of Pertussis compared to the US. The individuals developed the characteristic whoop during the paroxysm episodes followed by vomiting, more frequently (James D. Cherry. 1998, pp. 1430).