Persistent cough with whoop

Yesterday Asif (not a real name), a two years old boy came to me with his mother having a history of very irritating cough for two weeks. His mother told me that Asif was having serious cough and could not sleep at night.
While he was at my chamber, suddenly he started coughing and I noticed that the cough was very irritating and there was whoop. His eyes became red. I enquired about the vaccination status of the boy. His mother showed me the vaccination card. According to that vaccination card he is completely immunised as per EPI schedule.
Asif was suffering from Pertussis (Whopping cough). Asif’s mother argued with me that in spite of vaccination how he got pertussis. I tried to explain her the possibilities.
First the efficacy of the vaccine is not cent percent, development of the immunity is variable, vaccine adapted organisms may be a possibilities and new mutation of the organism sometimes to be considered as well. Anyway, vaccinated child do not suffer much in comparison to non-vaccinated child and early recovery is expected without complication if antibiotics like Azithromycin or Erythromycin could be started earlier.
Pertussis or whooping cough or hundred days cough is caused by a gram negative bacteria and it is very contagious. It spreads quickly from one person to another as droplet infection. Incubation period is 7 days to 21 days. There are three stages of the disease prodromal stage, paroxysmal stage and convalescent stage.
Complications of the disease sometimes may be very serious. There may be sub-conjunctival haemorrhage (bleeding underneath the conjunctiva), bronchopneumonia (a type of pneumonia, infection of the lungs), rectal prolapse (Rectal prolapse is a condition in which the rectum, the lower end of the colon located just above the anus, becomes stretched out and protrudes out of the anus), encephalopathy (brain disease), otitis media (inflammation of the middle ear), apnea (suspension of external breathing), sudden death may even occur.
Vaccination and isolation of the affected person is an important strategy to prevent the spread of the disease.

The writer works in the Department of Paediatrics at Community Based Medical College (CBMC), Mymensingh.
E-mail: mmukkhan@gmail.com