{"id":7166,"date":"2014-06-06T12:03:52","date_gmt":"2014-06-06T02:03:52","guid":{"rendered":"http:\/\/www.mvec.vic.edu.au\/?page_id=87"},"modified":"2024-09-06T14:34:25","modified_gmt":"2024-09-06T04:34:25","slug":"pertussis-whooping-cough","status":"publish","type":"references","link":"https:\/\/mvec.mcri.edu.au\/zh\/references\/pertussis-whooping-cough\/","title":{"rendered":"\u767e\u65e5\u54b3"},"content":{"rendered":"
<\/p>\n

What is it?<\/h2>\n

Pertussis (whooping cough) is a highly contagious, respiratory disease caused by an infection with the bacterium <\/span><\/span>Bordetella pertussis<\/span><\/span>. The bacteria attach to the cilia (tiny, hair-like structures) that line the upper respiratory system. The bacteria release toxins, which damage the cilia and cause airways to swell. Pertussis infection is usually more serious in infants <\/span>under <\/span>6 months<\/span>,<\/span> but<\/span> it can affect <\/span>people <\/span>of any age.<\/span><\/span><\/p>\n

What to look for<\/h2>\n

Symptoms begin 6 to 20 days after exposure and initially include rhinorrhoea (runny nose), malaise and a non-specific cough (the catarrhal phase). Approximately one week later, periods of coughing increase with intensity (the paroxysmal phase). A characteristic deep gasp (or \u201cwhoop\u201d) may be heard on inspiration, but this is not present in all infections.<\/span><\/p>\n

During or just following an episode of paroxysmal coughing, babies may have a period of apnoea where they stop breathing for a short period. This may be associated with some colour changes where their skin may appear blue or dusky, especially around the mouth.<\/span><\/p>\n

Complications of pertussis in infants can include vomiting and difficulty feeding due to prolonged paroxysmal coughing episodes. Rare complications of pertussis in infants include pneumonia and encephalitis, which can be fatal. Complications in older children and adults can include fainting episodes, sleeplessness and rib fractures due to paroxysmal coughing episodes.<\/span><\/p>\n

How is it transmitted?<\/h2>\n

Transmission of pertussis is through the inhalation of infected respiratory secretions that have been made airborne by coughing, sneezing and speaking. Pertussis is highly contagious, with one infected individual likely to transmit infection to 70\u2013100% of their household members. Some people with mild symptoms of pertussis may be unaware they are infected, but can still spread the bacteria to others. Humans are the only known reservoir for pertussis.<\/span><\/p>\n

The incubation period is 1 to 3 weeks. Without treatment, people with pertussis are considered infectious just prior to symptom onset and for 21 days thereafter. The infectious period is reduced to 5 days if a course of targeted antibiotics is completed.<\/span><\/p>\n

Epidemiology<\/h2>\n

Australia has historically experienced pertussis epidemics every 3 to 4 years. There is a seasonal pattern to pertussis infections with most cases reported in the spring and summer months.<\/span><\/p>\n

Infants under\u00a06 months of age have the highest rates of hospitalisation and death from pertussis infection. Aboriginal and Torres Strait Islander children under\u00a05 years have higher rates of pertussis infection and hospitalisation compared with non-Indigenous children of the same age.<\/span><\/p>\n

The introduction of the <\/span>maternal pertussis vaccination<\/span><\/a> program in 2015 saw a significant reduction in young infants infected with pertussis and a substantial reduction in both morbidity and mortality associated with infection. Between 2016 and 2018, infants under 2 months of age had the lowest incidence of disease, and children aged 9 to 11 years had the highest incidence of disease.<\/span><\/p>\n

Prevention<\/h2>\n

V<\/span>accination<\/span> against <\/span><\/span>Bordetella pertussis<\/span><\/span> is the most effective public health measure for <\/span>the prevention of pertussis for <\/span>both vaccine recipients (direct effect), and among unimmunised populations (indirect \u2018herd\u2019 effect)<\/span>.\u00a0 <\/span>V<\/span>accinati<\/span>on of <\/span>pregnant <\/span>people <\/span>a<\/span>lso<\/span> provide<\/span>s<\/span> short-term, <\/span>passive <\/span>protection <\/span>to infants through the <\/span>transpl<\/span>ace<\/span>ntal transfer of <\/span>antibodies<\/span>.<\/span><\/span><\/p>\n

P<\/span>ertussis vaccination is only available in Australia in combination with diphtheria and tetanus. Vaccines may also include protection against poliomyelitis, hepatitis B and haemophilus influenzae type B.<\/span><\/p>\n

The pertussis vaccines available in Australia are acellular, meaning they are made using pertussis toxin and\/or components of pertussis bacterium. In contrast, whole-cell pertussis vaccines are first generation pertussis vaccines that are made using an entire bacterium that has been inactivated. While whole cell pertussis vaccines are still available internationally, they were phased out in Australia in 1997, in favour of acellular pertussis vaccines.<\/span><\/p>\n

Primary course<\/h4>\n

As per the National Immunisation Program (NIP), a primary course of pertussis vaccination is given at 6<\/span> weeks, 4<\/span> months, and 6<\/span> months of age (Infanrix <\/span>h<\/span>exa<\/span>\/<\/span>Vaxelis<\/span>).<\/span><\/span><\/p>\n

Boosters<\/h4>\n

Booster doses are scheduled to be administered at:<\/span><\/p>\n

    \n
  • 18 months (Infanrix\/Tripacel)<\/span><\/li>\n
  • 4 years (Infanrix-IPV\/Quadracel)<\/span><\/li>\n
  • 12 to 13 years of age\/Year 7 high school program (Boostrix\/Adacel)<\/span><\/li>\n
  • pregnant people at 20\u201332 weeks gestation (every pregnancy, regardless of how closely spaced).<\/span><\/li>\n<\/ul>\n

    In addition, pertussis vaccination is recommended (but not funded) for:<\/span><\/p>\n

      \n
    • parents\/guardians of a baby under 6 months of age (if they have not received a dose in the last 10 years)<\/span><\/li>\n
    • adults aged 65 years and older who have not received a pertussis-containing vaccine in the last 10 years<\/span><\/li>\n
    • any adult who wishes to be protected against pertussis infection who has not received a dose in the last 10 years (including healthcare workers, travellers, and early childhood educators and carers).<\/span><\/li>\n<\/ul>\n

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