Medicus, Vol. 14 No. 1_ARI, 2005.
Pregledni rad
Pertussis – Clinical Picture, Diagnosis, Therapy and Prevention
Ana Baće
Sažetak
Pertussis is a highly contagious acute
respiratory infection caused by gram-negative pleomorphic
bacillus Bordetella pertussis (BP). Typical cases include
whooping cough in infants and young children, with relatively
frequent severe and potentially fatal complications. In spite of
great progress in its prevention and therapy, pertussis remains
an infectious diseases requiring continuous caution. Even in
highly developed countries, pertussis represents a problem
among preventable childhood diseases. Although the incidence
of pertussis is dramatically reduced by high vaccination rates
and reduced BP circulation, its occurrence and epidemiologic
role in young infants and adults is increasing. The actual
incidence of pertussis is probably much higher than that
offi cially declared. In Croatia, it reaches 2.7 - 18.8 cases /100
000 inhabitants, while the primo- and revaccination rate is about
90%. Total pertussis lethality rate reaches 0.1%, and 0.5% - 1%
in infants. Children below 12 months of age account for 75%
of death cases. Man is the only BP host. Pertussis is spread
by droplet infection and its contagiosity in susceptible persons
is almost 100%, while in in-house contacts it is 70-100%.
Besides by BP, pertussis can be caused by B. bronchiseptica,
adenoviruses, RSV, M. pneumoniae, C. trachomatis and other
respiratory viruses. The clinical picture of a bordetella infection
largely depends on the patient age, previous infection or
immunization, passively acquired antibodies and other factors
(exposition rate, inherited and acquired patient characteristics,
bordetella genotype). It can be typical or atypical, and specifi c
in some subpopulations (newborns, infants, pregnant women,
infected adults). The cultivation of B. pertussis remains the
gold standard for the etiologic diagnosis. The enzyme-linked
immunosorbent assay (ELISA) is frequently used. B. pertussis
can be also directly detected in nasopharyngeal secretion by
direct fl uorescent antibody test (DFA) and polymerase chain
reaction (PCR). The etiologic pertussis treatment includes
macrolides. It is usually supplemented with symptomatic and
supportive measures. Prevention and prophylaxis are based on
immunization, chemoprophylaxis and isolation.
Ključne riječi
Bordetella pertussis; pertussis; epidemiologic features; clinical picture; diagnosis; treatment; prevention; parapertussis
Hrčak ID:
18538
URI
Datum izdavanja:
26.1.2005.
Posjeta: 14.259 *