CDC Pink Book, Pertussis

Summer Yanca

Health Science, California State University Channel Islands

BIOL 432: Epidemiology and Environment

Professor Zin Htway

Summer Yanca

October 20, 2023

 Pertussis is an acute infectious disease that is caused by the bacterium, Bordetella

pertussis (Haver et al.,2022). The bacterium is a tiny, aerobic gram-negative rod. It requires an

oxygenated environment to live and grow. Bordetella pertussis (B. pertussis) can produce

multiple antigenic and biologically active products. These products can include pertussis toxin

known as PT, filamentous hemagglutinin, tracheal cytotoxin, and more. The products produced

from B. pertussis can be crucial to an individual’s health. These products are responsible for the

infection of pertussis. An immune response to one or another one of these products follows

immunity which is not permanent. The Centers for Disease Control and Prevention (CDC)

defines pertussis as a toxin-mediated disease. B. pertussis attaches to the cilia part of a

respiratory epithelial cell and injects toxins which paralyzes the cell. This leads to the respiratory

tract becoming inflamed and interfering with clearings of pulmonary secretions. Secretions

known as phlegm or sputum are critical for the respiratory tract as they provide lubrication and

trap irritants in airways (American Lung Association, 2021).

Pertussis is known to have a common incubation period of 7 to 10 days. But it can range

anywhere from 4 to 21 days. The clinical course of illness from pertussis has three stages:

catarrhal, paroxysmal, and convalescence (Havers et al., 2022). The first stage includes onset of a

runny rose, low fever, and mild cough. The cough can be gradually more severe where about the

paroxysmal stage begins after one to two weeks. The CDC describes that the paroxysmal stage

diagnosis is usually suspected among patients. During this stage, paroxysms occur which are

bursts of rapid coughs. This happens from the thick mucus coming from the tracheobronchial

tree. Paroxysmal attacks occur commonly at night rather than during the day. These attacks can

last anywhere from one to six weeks but may persist up to 10 weeks (Havers et al., 2022). Lastly,

the convalescent stage is a gradual recovery back to normal health. The cough becomes
aggressive and dissipates over time. The CDC includes that previously vaccinated individuals

may become infected but experience a milder infection than infants and kids (Havers et

al.,2022). Although mild infections in individuals can still infect others and transmit the disease.

Also, pertussis may be asymptotic in some individuals and be transmittable.

The CDC claims that the most frequent complication with pertussis is secondary bacterial

pneumonia. Neurological complications can also be a result from having pertussis. These

complications are more common in children and infants as data shows. Most of the pertussis

related deaths stem from children and infants. Some other complications that are pressure related

include pneumothorax, epistaxis, hernias, etc. Adolescents and adults can develop complications

as well such as difficulty sleeping, pneumonia, rib fractures and weight loss (Havers et al., 2022).

Antibiotics are used to treat pertussis and are of value if they are administered early

during being infected with the disease. The CDC includes how the course of pertussis can be

modified to be shorter if antibiotics are administered before the paroxysmal stage occurs. Some

of the recommended antibiotics are azithromycin, clarithromycin, and erythromycin. These

antibiotics eradicate B. pertussis from secretions which decrease communicability among the

organisms (Havers et al., 2022). Other preventive measures consist of vaccinations against

pertussis. The DTaP and Tdap vaccines are essential immunizations for pertussis that also protect

one from tetanus and diphtheria. Pertussis is a highly communicable disease, so vaccines are

highly recommended by the CDC. The transmission of pertussis consists of respiratory droplets

between close contact or airborne droplets of respiratory secretions (Havers et al., 2022).
 References:

American Lung Association. (2021, July 14). Understanding mucus in your lungs.

www.lung.org. https://www.lung.org/blog/lungs-mucus

Havers, F., Moro, P., Hariri, S., & Skoff, T. (2019). Pinkbook. CDC.

https://www.cdc.gov/vaccines/pubs/pinkbook/pert.html