Whooping Cough (Pertussis)
Whooping cough, or pertussis, is very contagious and primarily affects infants and young children. Whooping cough is caused by a bacterium called Bordetella pertussis. The illness is characterized by paroxysms (intense spells) of coughing that end with the characteristic "whoop" as air is inhaled. Whooping cough caused thousands of deaths in the 1930s and 1940s. With the advent of a vaccine, the death rate has declined dramatically. Pertussis vaccines are very effective. However, if pertussis is circulating in the community, there is a possibility that a fully vaccinated person could catch the disease. Babies who are too young to receive the vaccine are also at very high risk of catching pertussis. The illness can be very serious, even sometimes fatal, in young infants. Many babies infected with pertussis have caught it from an adult.
The disease starts like the common cold, with a runny nose or congestion, sneezing, and sometimes a mild cough or fever. Usually, after one or two weeks, severe coughing begins. The following are the most common symptoms of whooping cough. However, each individual may experience symptoms differently. Infants less then 6 months old may not have a classic whooping cough, or it may be difficult to hear. Instead of coughing, infants may have a pause in their breathing, called apnea, which is very serious. You should consult your doctor or call 911 if you observe pauses in breathing. Symptoms of whooping cough may include:
- Coughing, violently and rapidly, until all air has left the lungs and a person is forced to inhale, causing a "whooping" sound
- Nasal discharge
- Sore, watery eyes
- Lips, tongue, and nailbeds may turn blue during coughing spells
Whooping cough can last up to 10 weeks and can lead to pneumonia and other complications.
The symptoms of whooping cough may resemble other medical conditions. Always consult your doctor for a diagnosis.
In addition to a complete medical history and medical examination, diagnosis of whooping cough is often confirmed with a culture taken from the nose.
Specific treatment for whooping cough will be determined by your doctor based on:
- Your overall health and medical history
- Extent of the condition
- Your tolerance for specific medications, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
Antibiotics are typically given within 3 weeks of the onset of cough in babies over age one year, and within 6 weeks of the onset of cough in infants younger than age 1 year. Pregnant women also are treated with antibiotics. Antibiotics help to prevent the spread of infection after 3 to 4 days of treatment. Other treatment may include:
- Keeping warm
- Eating small, frequent meals
- Drinking plenty of fluids
- Reducing stimuli that may provoke coughing
Hospitalization may be required in severe cases.
Although a vaccine has been developed against whooping cough, which is routinely given to children in their first year of life, cases of the disease still occur, especially in infants younger than age 6 months.
A dramatic increase in the number of cases of pertussis has occurred since the 1980s, especially in preteens and teenagers ages 10 to 19, and in babies less than age 6 months. The CDC recommends that children get five DTaP shots for maximum protection against pertussis. A DTaP shot is a combination vaccine that protects against three diseases: diphtheria, tetanus, and pertussis. The first three shots are given at ages 2, 4, and 6 months. The fourth shot is given between ages 15 and 18 months. The fifth shot is given when children enter school at ages 4 to 6 years. At their regular checkups, 11- and 12-year-olds should get a dose of Tdap. The Tdap booster contains tetanus, diphtheria, and pertussis. If an adult did not get a Tdap as a preteen or teen, then he or she should get a dose of Tdap instead of the Td booster. All adults ages 19-64 years should get a Td booster every 10 years. It also can be given before the 10-year mark. Adults ages 65 and older should get a one-time booster if they are going to be around newborns and infants younger than 12 months old. Pregnant women who are not already vaccinated should get the booster late in the second trimester or in the third trimester. Always consult your health care provider for advice.
Click here to view the
Online Resources of Infectious Diseases