Introduction
Causes, Symptoms, Mode of Transmission
Bordetella pertussis is the bacteria responsible for whooping cough or pertussis. When an infected person sneezes or coughs, microscopic bacteria droplets are emitted into the environment and inhaled by surrounding individuals. After an individual is exposed to pertussis, it takes seven to ten days or longer for symptoms to manifest. Signs include coughing, runny nose, rhinitis, red and watery eyes, and increased temperature (Maertens et al., 2020). These clinical signs worsen in a week or two as thick mucus collects within the airways, resulting in persistent coughing. The severe and continuous cough may induce vomiting, a crimson or blue face, excessive exhaustion, and a high-pitched whoop with the subsequent inhalation (Maertens et al., 2020).
Complications and Treatment
Pertussis can lead to life-threatening complications in infants and young children. These severe effects are particularly likely to affect young ones who have not received all of the necessary pertussis vaccinations. 2 in 3 infants younger than one-year-old who undergo hospital care for pertussis develop apnea, 1 in 5 develop pneumonia, 1 in 50 develop convulsions, 1 in 150 develop brain illness, and 1 in 100 die (“Complications,” 2022). Both adults and adolescents also experience problems such as fainting, fractured ribs, decreased bladder control, and weight loss. Adults and children older than one year should begin pertussis treatment within three weeks of cough onset. Babies less than one year and expectant women should be treated within six weeks of the onset of cough. Erythromycin, Clarithromycin, and Azithromycin are the indicated antimicrobial medicines for managing this illness (Alekseeva et al., 2021). Moreover, clinicians can utilize Trimethoprim-sulfamethoxazole.
Demographics
In Florida, 15 occurrences of whooping cough were documented in 11 counties in 2023, for example. The rate of pertussis cases recorded between September 2022 and February 2023 increased by 25% compared to September 2021 through February 2022 (“Pertussis (Whooping cough),” 2023). In February 2023, there were no pertussis episodes linked to households. In the previous six months, there was a mean of one household-related case and seven total instances. From September 2021 to February 2022, there were an average of 0 cases associated with households and 5 cases overall (“Pertussis (Whooping cough),” 2023). For most pertussis cases, interaction with other confirmed instances is not established, and outbreaks cannot be connected.
Determinants of Health
Although anybody can contract pertussis, neonates will likely become severely ill or succumb to the infection. This issue is particularly true for infants younger than two months who cannot receive the immunization yet. Evidence shows that giving expectant women the Tdap (tetanus, diphtheria, and acellular pertussis) vaccine can protect their infants from pertussis. According to research, three factors influence the prevalence and incidence of pertussis. Delays in detecting and eradicating instances, inherent periodic changes, and possibly pathogen-specific alterations are disease-related factors (Quattrocchi et al., 2019). Pertussis incidence is also connected to healthcare control factors, such as disparities in physician understanding or non – utilization of laboratory diagnostics (Quattrocchi et al., 2019). Inadequate vaccination coverage and declining vaccine-mediated immunity are booster-related drivers.
Pertussis can affect any age group. Pertussis is being identified in a growing proportion of adults and adolescents. Currently, the age groups with the highest pertussis diagnosis rates are newborns younger than one year and adolescents aged 10 to 20. Regardless of age, persons who have yet to receive the appropriate number of pertussis vaccine shots are at risk. In contrast to ailments such as chicken pox (varicella) and measles, it is possible to contract pertussis more than once in a lifetime due to the short-lived nature of the antibodies produced by infection or vaccination.
Epidemiological Triad
The mucosal lining of the respiratory system tract is a natural home for B pertussis and B para-pertussis. Although B pertussis can live outside the body for a few days and can thus be spread through unclean surfaces, the vast majority of infections result from direct contact with infected individuals, specifically inhalation of bacteria-laden cough spray droplets (Mamchik et al., 2020). During the initial catarrhal phase, the patient is most susceptible when clinical manifestations are moderate and non-specific. Subacute events may have equal epidemiologic importance. It is assumed that asymptomatic bearers of B pertussis or B para pertussis play no important epidemiologic contribution (Mamchik et al., 2020). B bronchiseptica’s natural home is the respiratory tracts of small animals such as rabbits, cats, and dogs. Thus, B bronchiseptica infections in humans are uncommon and only arise after direct contact with animal carriers.
Historically, pertussis, an extremely infectious global virus, was widespread and deadly, killing tens of thousands of children annually. Incidence and death have decreased steadily over the years due to widespread immunization, but huge numbers of patients continue to perish in nations where vaccination coverage is low. Newborns and children are most susceptible to whooping cough; however, susceptibility is widespread. During the first six months of life, the sickness is most hazardous. Season and climate appear not to affect the mortality rate.
Role of the NP
NPs have the potential to contribute substantially to the delivery of preventative care, which primary care physicians have historically done. Up to 90 percent of NPs are trained in general practice and can administer 80 to 90 percent of physician-provided treatment. In addition, whereas medical training concentrates on evaluation and therapy, NP education emphasizes patient-centered care for patient needs, families, and communities. NPs also have a significant role in preventing and promoting health across the lifetime. NPs are uniquely positioned to affect patient behavior by establishing strong, trustworthy, and long-lasting connections. Through one-on-one conversations, NPs can inspire patients to make healthier decisions and adopt healthier lifestyles to prevent chronic disease. Primary care physicians have typically provided preventive care.
The Johns Hopkins Nursing Evidence-Based Practice Model is a potent problem-solving strategy for clinical decision-making supported by a user-friendly individual or group application tools. It employs a three-step procedure known as PET: practice question, evidence, and translation (Liza Anicoche & Kaiser, 2021). It is intended expressly to address the needs of practicing nurses. The concept aims to ensure that the most recent study results and best – practices are rapidly and effectively implemented into patient care. Thus, NPs adopting this paradigm could aid in preventing communicable diseases such as pertussis through current research and preventative strategies.
Conclusion
In conclusion, pertussis can affect persons of all ages, including those vaccinated or who previously had the disease. Pertussis is most prevalent among school-aged children and adolescents but can also affect adults. Vaccination is the most effective means of preventing pertussis in infants, children, adolescents, and adults. Treatment with antibiotics as soon as possible is crucial. Antibiotics may lessen the severity of the disease if they are administered early, prior to the onset of coughing fits. Antibiotics can also prevent the disease from spreading to close acquaintances. Pertussis can sometimes be very dangerous and may necessitate hospitalization for treatment. Infants are most susceptible to major problems.
References
Alekseeva, I. A., Perelygina, O. V., & Kolyshkina, E. D. (2021). Pertussis vaccines and the role of Bordetella pertussis lipooligosaccharide in the immune response to pertussis infection and vaccination. BIOpreparations. Prevention, Diagnosis, Treatment, 21(1), 10-19. https://doi.org/10.30895/2221-996x-2021-21-1-10-19
Complications. (2022, September 7). Centers for Disease Control and Prevention. https://www.cdc.gov/pertussis/about/complications.html
Liza Anicoche, P. I., & Kaiser, C. L. (2021). The Johns Hopkins evidence-based practice (EBP) model: Weinberg Perianesthesia interventions for a healing environment. Journal of PeriAnesthesia Nursing, 36(4), e21. https://doi.org/10.1016/j.jopan.2021.06.064
Maertens, K., Edwards, K., & Leuridan, E. E. (2020). Pertussis. Maternal Immunization, 169-190. https://doi.org/10.1016/b978-0-12-814582-1.00009-7
Mamchik, N. P., Gabbasova, N. V., Sitnik, T. N., & Steinke, L. V. (2020). Pertussis in the Voronezh region: Epidemiology and vaccination. Epidemiology and Vaccinal Prevention, 19(2), 79-86. https://doi.org/10.31631/2073-3046-2020-19-2-79-86
Pertussis (Whooping cough). (2023, March 8). Florida Department of Health. https://www.floridahealth.gov/diseases-and-conditions/vaccine-preventable-disease/pertussis/index.html
Quattrocchi, A., Mereckiene, J., Fitzgerald, M., & Cotter, S. (2019). Determinants of influenza and pertussis vaccine uptake in pregnant women in Ireland: A cross-sectional survey in 2017/18 influenza season. Vaccine, 37(43), 6390-6396. https://doi.org/10.1016/j.vaccine.2019.09.008
write