(pertussis, 100-day cough)

Bacterial respiratory infection, little or not febrile, highly contagious and the evolution of which can be long. Two bacteria of the Bordetella type are responsible for the disease in humans: Bordetella pertussis and Bordetella parapertussis. Whooping cough is highly contagious especially in its first phase while it often goes undiagnosed. Transmission takes place by air: the bacteria responsible for the disease are spread by droplets of saliva expelled during cough or sneezing .
Once in the airway, the bacterium multiplies on the  respiratory ciliated epithelium of the trachea and the bronchi. It produces several specific toxins causing the disease: whooping cough is a disease linked to those toxins.

The long illness lasts for 4 to 8 weeks, after an incubation period of one week (5-21 days). The disease then enters into a catarrhal period during which non-specific signs of infection of the upper airways are observed. It can be confused with a simple cold. It lasts 1 to 2 weeks. It is followed by the period of coughing fits, characteristic of whooping cough. Each fit consists in five expiratory jolts followed by a long high-pitched whoop or gasp. During this phase, the child is exhausted by the succession of fits. The coughing can also cause seizures in young children and choking, vomiting, apnea, cyanosis. Between coughing fits, the clinical examination is normal, there is no fever. This period lasts from 2 to 4 weeks. Clinical picture for infants of less than 6 months of age is less typical: runny nose and cough are less marked; fits of cough are few but the apnea and fits of cyanosis are predominant.

Complications of whooping cough are rare since the vaccination campaigns: middle ear otitis, pneumonia, atelectasis, convulsions, encephalopathy, weight loss, and even death. More, it can be particularly serious for the unvaccinated infant whose mother has not transmitted her antibodies. That is why it is recommended to young parents to be vaccinated, in order to protect their children who will be vaccinated from the age of 2 months.

Anesthetic implications:

References : 

-        Couchot E, Paut O, Ghez O, Charpentier A, Ughetto F.
L’oxygénation extracorporelle artérioveineuse est-elle utile dans le traitement de la coqueluche maligne ?
Ann Fr Anesth Réanim 2009 ; 28 : 74-7

Updated: October 2016