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Immunization

Pertussis

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The Disease:

Pertussis is a respiratory infection characterized by a signature cough. During severe coughing spells, the infected child may have difficulty breathing and make a “whooping” noise as he or she tries to inhale. (Thus giving the disease its colloquial name: whooping cough.) Pertussis can result in several life-threatening complications, including pneumonia, seizures, encephalitis (inflammation of the brain) and in some cases, death. The disease most often strikes young children, but adults also suffer from the disease and may pass it on to infants that have not been immunized.

Pertussis is caused by a bacterium, Bordetella pertussis, that invades the respiratory tract. The disease is very contagious and is spread by droplets when an infected person coughs or sneezes. A child can also become infected after coming in contact with a sick person’s saliva or phlegm, or through contaminated objects.

Symptoms:

Pertussis can be difficult to diagnose because the initial symptoms are not unlike those of a cold – runny nose and a cough. Symptoms may appear two days to two weeks after exposure to the bacteria. Gradually, the coughing fits become more violent and prolonged. Some children may vomit or cough up discharge, or, in more severe cases, may develop respiratory infections that can make breathing difficult.

Immunization:

There are two types of pertussis vaccine, whole cell and acellular. Whole cell pertussis vaccine uses a killed version of the bacterium that causes the disease. Acellular pertussis vaccine is a newer variation that utilizes only some elements of this bacterium, rather than the whole killed bacteria. While both are effective in preventing the disease, the advantage of the acellular is that it reduces the chance of mild side effects associated with the whole-cell vaccine: fever and swelling, redness or soreness in the arms. However, because the acellular vaccine is much more expensive to produce, the whole-cell vaccine, which is equally effective, is more frequently used in developing countries. Either of these pertussis vaccines can be bundled in the combination diphtheria, tetanus, and pertussis shot (DTP). The World Health Organization (WHO) recommends that DTP be given at six weeks, 10 weeks and 14 weeks.

Goal:

By 2010, ensure routine childhood immunization of children under one year of age at 90 per cent nationally, with at least 80 per cent coverage in every district or equivalent administrative unit.

Sources: WHO, CDC, UNICEF