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Diseases / Pertussis

Pertussis

What is it?: 

Pertussis is an important cause of morbidity and mortality in infants worldwide, and continues to be a public health concern despite high vaccination coverage. The disease, caused by the bacte­rium Bordetella pertussis, is endemic in all countries. Epidemic cycles have been occurring every 2 to 5 years, even after the introduction of effective vaccination programmes and the achievement of high vaccination coverage.1

Clinical features: 

It is also known as ’whooping cough’. The infected person may initially have non-specific symptoms like runny nose, sneezing, low-grade fever and mild cough. The cough gradually becomes more severe and spells of violent coughing can interfere with eating, drinking and breathing. The bacteria can cause lung infection, and even lead to seizures and coma in severe cases.2

Mode of transmission: 

It is transmitted by direct contact with droplets from patients. 2

The number of pertussis cases recorded by the Centre for Health protection had been increased from 20-25 cases per year in 2011-2016 to 69 cases in 2017, and further to 110 cases in 2018 which is the highest annual number recorded in past few decades.3

Incubation period: 

The incubation period ranges from 4 - 21 days, usually 7 - 10 days.2

Prevention: 

Maintain good personal hygiene2

  • Wash hands frequently with liquid soap and water, especially before touching the mouth, nose or eyes, or after touching public installations such as handrails or door knobs.
  • Cover nose and mouth with tissue paper when coughing or sneezing, and wash hands thoroughly afterwards. Dispose of soiled tissue paper in a lidded rubbish bin.
  • Put on a surgical mask when having respiratory symptoms. Refrain from work or school and seek medical advice promptly.

Maintain good environmental hygiene2

  • Maintain good indoor ventilation
  • Frequently clean and disinfect touched surface such as furniture, toys and commonly shared items
  • Use absorbent disposable towels to wipe away obvious respiratory secretions, and then disinfect the surface and neighbouring areas with 1:49 diluted household bleach, leave for 15 - 30 minutes and then rinse with water and keep dry

Vaccination

  • Active immunisation with pertussis vaccine is an effective way to prevent the disease. In the current Hong Kong Childhood Immunisation Programme, a combined diphtheria, tetanus, acellular pertussis and inactivated poliovirus vaccine (DTaP-IPV) is used for preschoolers and Primary One students (Please refer to the Hong Kong Childhood Immunisation Programme). It offers good protection and the disease is milder in those who are infected after immunisation.2
  • According to the Consensus Statement from CHP, Pregnant women are recommended to have Pertussis containing vaccine in order to give babies from new born until 2 months old for the basic protection against pertussis.3 World Health Organization (WHO) mentioned that cocooning strategy has been recommended in certain developed countries – includ­ing Australia, France, Germany and the USA.1 Please consult your family doctor for details about vaccination against pertussis.
Managment: 

Antibiotic is useful in treating the disease. A child who has persistent fever and cough with distressing gasp during the cough episode should be brought immediately to hospital.2

Reference:

  1. World Health Organization. Weekly epidemiological record. Pertussis vaccines: WHO position paper - August 2015. 2015;35(90):433-460.
  2. Centre for Health Protection. Communicable diseases – Pertussis. 2019. [ONLINE] https://www.chp.gov.hk/en/healthtopics/content/24/35.html  (Accessed 2 Feb 2020).
  3. Centre of Health Protection (2019), Scientific Committee on Vaccine Preventable Disease, Consensus Recommendations on Pertussis Vaccination for Pregnant Women in Hong Kong.

MAT-HK-2100124-1.0-02/2021