Introduction

Highly contagious acute bacterial disease involving the respiratory tract. The occurrence is worldwide and causes at least 20 million cases of pertussis, 90% of which occur in developing countries with an estimated 200,000 to 300,000 fatalities each year.

Causative agent: Bordetella pertusis

Transmission: Direct contact with airborne discharges from the respiratory mucous membranes of infected persons.

Incubation period: Commonly 9-10 days, range 6-20 days

Although pertussis can occur at any age, most serious cases and fatalities are observed in early infancy and mainly in developing countries.

Sign & Symptoms

Insidious onset of irritating cough, gradually become paroxysmal, usually within 1-2 weeks and lasts for 1-2 months or longer.

Paroxysms are characterized by repeated violent coughs each series of paroxysms has many coughs without intervening inhalation and can be followed by a characteristic crowing or high-pitched inspiratory whoop.

Expulsion of clear, tenacious mucus, often followed by vomiting.

Complication

Pneumonia, encephalitis and malnutrition due to repeated vomiting.

Treatment

Specific treatment:

Antibiotics: Erythromycin, Clarithromycin or Azithromycin to shorten the period of communicability.

Prevention & Precautions

All travelers should be up to date with the vaccine.

Type of vaccine: Pertussis as whole cell or acellular preparation

Number of doses: At least three, given i.m

Schedule: 2, 3 and 5 months of age according to the Malaysian National Immunization Program.

Booster: 18 months

Contraindications: Adverse reaction to a previous dose.

Adverse reactions: Mild local or systemic reaction is common

Before departure: As long as possible. Some protection after second dose

References organisation/ support

International Travel & Health, WHO 2006

Control of Communicable Diseases Manual, 18th Edition by David L. Heymann, MD, Editor, 2004

National Immunization Program, Ministry of Health Malaysia.

www.dph.gov.my/cdc/childhoodimmunisation