Understanding Pertussis: The Whooping Cough Disease

Significance of Pertussis

Pertussis is an important communicable disease in which we must be aware of, it is exceedingly contagious. The main sign that one portrays when this disease is present is uncontained aggressive coughing, which can lead to difficulty in breathing to some individuals. Whooping cough is also another name for pertussis mainly because a whooping sound is heard when the patient tries to breath. Pertussis, is an upper respiratory infection caused by the Bordetella pertussis bacteria. Common cold like symptoms occur about a week after exposure to the bacteria. The whoop noise is rare in patients under 6 months of age.

A major concern with pertussis is when a patient has coughing spells leading to vomiting or a short loss

of consciousness. Infants the most deserving of supervision may experience choking spells and long pause in between their breathing, which is a common sign. In severe cases hospitalization is required. Therefore, it is wise to consider pertussis if vomiting occurs while coughing. The significance of pertussis is how to prevent, and knowing the signs, and symptoms in order to not fall in the category of illnesses that can cause severe complication to one's health and to some eventually results to death.
Pertussis Issue of Concern

The more new cases that are reported, the more concerned we should become, with question such as why so many new cases? According to Gore, A (2014), pertussis is a recurring disease and peaks every 3-5 years in the state of California, where the latest peak come about in 2010. We do not want such climax and would encourage pregnant women especially, to get vaccinated to prevent severe disease and death to infants. Then, later parents are recommended to vaccinate the infant. Infants that are just too young to be fully immunized remain most susceptible to severe and critical cases of pertussis. About two-thirds of pertussis hospitalizations have been in children four months or younger, whereas in California two infant deaths have been reported within that age group (Gore, A, 2014). It may be known that vaccination and/or illness from pertussis does not offer a lifetime immunity, however, vaccination is the best resistance adjacent to pertussis.
Why it is Important to Understand Pertussis
Pertussis as mentioned before is a serious disease, it can affect people of any age.

The method of transmission is airborne, by way of an infected person sneezing or coughing. The droplets from the sneeze or cough contains the Bordetella pertussis bacteria moving through the air within the atmosphere making it easy to transmit to an uninfected person. The disease typically lasts 6 weeks, but can last as long as 10 weeks. It is important to understand pertussis so that if anything remotely relating to the symptoms of pertussis occur such as: common cold, severe coughing, whoop noise, runny nose, slight fever and or diarrhea the patient understanding will lead him or her to contact their health provider. In older children, the prognosis is usually very good, infants are the highest at risk (Kaneshiro & Zieve,

2014).
The person with pertussis should be treated, and people who are in close contact should get preventive antibiotics such as erythromycin. But, most patients are diagnosed too late to make the symptoms go away. The body's immune system is weakened when you are pregnant and as a result you may be less able to fight off disease, escalating the risk of becoming critically ill and even premature birth because of the flu. Flu vaccine can be given to a pregnant woman safely at any stage of the pregnancy ("NEW WHOOPING COUGH" 2015). Therefore, it important to understand pertussis to eliminate the possibility of getting the disease.
Importance to Finding a Solution for Pertussis
Without a solution possible complications will occur in regards to the patient health status. Pneumonia which is the lungs being filled with fluid or inflammation of the lungs air sacs will cause cough with pus, fever, chills or difficulty breathing. Permanent seizure disorder, nose bleeds, ear infections, brain damage from lack of oxygen, bleeding in the brain are a few other complication due to pertussis. The best method to prevent pertussis infection is to get the pertussis vaccine. In children it is usually given as a shot along with other vaccines. The most frequent type called DTaP, diphtheria, tetanus and pertussis, protecting not only against pertussis but diphtheria and tetanus as well (Spencer, Sockrider, & Moore, 2015).
A total of five DTaP vaccines are recommended which are typically given to children at ages 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years. The Tdap vaccine for pre-teen, teens and adolescents should be given at age 11 or 12. Recommendation was also made to emphasize that adults age 19 to 64 should receive one dose of the Tdap vaccine against pertussis. Adults age 65 years and older need a one-time whooping cough booster if they will have close interaction with infants younger than 12 months. The most important of them all at the very beginning, pregnant women should get a dose of Tdap during every pregnancy between 27 and 36 weeks of each pregnancy, to protect the newborn from pertussis (Kaneshiro & Zieve, 2014).
Implications for Pertussis for CHN practice
The parents who decides to skip or delay vaccinations not for medical reasons, but for personal beliefs mostly is due to unproven fears about vaccine safety. Quite a few states had vaccination exemption rates that surpassed the national average. The maximum exemption rates were found in Idaho (6.5 percent), Vermont (6.1 percent), Oregon (6 percent), Alaska (5.8 percent) and Michigan (5.3 percent) ("Despite Pockets of Resistance" 2015). Oregon law requires that children in school, preschool, or a childcare facility need proof that they are protected against diphtheria, tetanus, and pertussis except if an exemption is acquired ("Oregon: Media Release" 2015). According to Oregon: Media Release whooping cough is a serious health concern in Oregon with more than 60 cases documented last year in Deschutes County. Vaccine coverage in both developed and developing countries remains extremely low, and there have been numerous updates in the past years that may have enabled some providers, thus adequate vaccination coverage have continued to be a major obstacle (Blaylock & Hartzell, 2014).
According to Blaylock & Hartzell, (2014) despite a record number of pertussis cases in 2012, data propose that just 14% of all adults and 26% of those living with infants had received Tdap. The issue here is that, worldwide an estimated 22.6 million children did not complete the appropriate pertussis vaccination series which was discussed further up in the research paper. Whereas, the 3 doses recommended to be given at 2, 4 and 6 months. Pregnant women, infants, teens, adolescents, adults and elders including healthcare workers must take action to prevent this disease. It is sad to say that a low rate exist for healthcare workers not taking action to be vaccinated. As healthcare workers we are required to educated, screen, establish a nurse/patient relationship with our patients to enable them to trust our reasons to why the pertussis vaccination is important to take. So imagine a situation in which your educating a patient and he or she asked have you taking the vaccine, what reason will you provide to the patient to benefit their health. We as healthcare workers cannot just blatantly lie and say yes for that is only jeopardizing the care to the patient.
Health Care Organizations Included in the Topic of Pertussis
All healthcare organization including hospitals, clinics, urgent care, pharmaceutical are obligated in knowing the who, what, when, and how to take care of a patient wanting or not knowing about the pertussis disease. Education and knowing is of great importance, with it comes knowledge, therefore, when knowledge is gained prevention in getting pertussis is achieved. Even, when it's too late some medication can help lessen the patient's ability to spread the disease to others. Pertussis is a worldwide communicable disease, it is mostly seen in areas where a small group of people are vaccinated and health or medical care is less accessible. Pertussis infects a large number of people yearly, and in part have killed many. Schools are also a place of concern for uninfected children to become infected. According to ("Old college try applying", 2015) schools and day cares have had the most concentrated number of cases of pertussis. Preventative measure are imperative so that children do not get the disease.
As a health care professional different screening are performed to improve pertussis vaccination. Once a patient is admitted screening and if probable vaccinate parents of infants and children, all emergency room visits, and pregnant women at appropriate trimester. Simply screening at different visits when possible can eliminate an individual from having the disease. Within the community adding pertussis vaccination to annual flu drive campaign can be of beneficial to the environment. Even conducting hospital pertussis drives will help the health care professional and get vaccinated, hold monthly vaccination clinics (outreach to low-resource areas), performing electronic medical record review and contact patients without pertussis vaccination all improves a wide case of pertussis existing in the environment (Blaylock & Hartzell , 2014).
Conclusion
The main action to take is to report any symptoms to the health care provider as soon as possible.

Treatement provided are antibiotic such to diminish the disease from getting worst. If too late the aantibiotic will not be effective, but it can reduce the patient or individual ability to spread the disease to others. Babies most vulnerable are at high risk, pregnant women should take the vaccine to prevent premature babies and other possible complication. Teen, adults and elders are also recommended to take the pertussis vaccine. No person infected should return to daycare, school or work until they have completed the antibiotic treatment. Because pertussis is an airborne respiratory disease , it is considered to be a droplet precaution , where surgical mask is required when entering a patient with the disease if close contact is

expected.