What is Whooping Cough (Pertussis)?

DEFINITION:

An intense cough with difficulty breathing caused by the pertussis bacterium.

SYMPTOMS:

  • Congestion
  • Cough
  • Cold symptoms

The cough is mild at first but gradually worsens to the point where the child is coughing so hard and so quickly that they have to forcefully inhale, making a whooping sound.

CAUSES:

A bacterium called Bordetella pertussis affects the upper airway.

CONTAGION:

This is a very highly contagious illness. Ninety-seven to one hundred percent of susceptible people will get the illness if exposed. Exposure is by respiratory droplets from coughing or sneezing. The incubation of pertussis runs from 6-20 days with an average of 7days.

DIAGNOSIS:

The diagnosis is made by the symptoms. Knowledge of an exposure to an infected individual and the immunization status can be helpful. A blood test or rapid antibody test from a throat swab can confirm the diagnosis.

TREATMENT:

Once the illness is in the paroxysmal stage, antibiotics such as erythromycin or ampicillin will lessen the contagion of the effected individual but not the course of the illness. Antibiotics can shorten the course if given in the catarrhal stage. Exposed, susceptible individuals should receive erythromycin and the vaccine (if they are due according the vaccine schedule). For children in the paroxysmal stage, oxygen, hydration and nutrition are supportive until the illness passes.

DISCUSSION:

Pertussis is one of the most highly contagious illnesses. Once exposed, an unvaccinated child will almost certainly contract this disease. The symptoms of this illness are divided into three stages: The catarrhal, paroxysmal, and convalescent.

The catarrhal stage begins after a six to twenty-day incubation period. It is characterized by cold symptoms such as congestion, mild cough, low-grade fever, and watery eyes. This stage lasts one to two weeks. Then the paroxysmal stage occurs. The cough becomes more severe. A child will forcefully cough multiple times followed by a deep inspiration which sounds like a “whoop”. The coughing is so hard that it can cause vomiting. This stage lasts two to four weeks. After this is the convalescent stage. The coughing decreases in frequency and severity. This lasts one to two weeks. The cough may last months and may recur for years after subsequent exposures to cold viruses. The paroxysmal stage is the most dangerous. Complications such as pneumonia and airway obstruction with mucus can make breathing difficult. There can be a lack of oxygen causing seizures and coma. Treatment is helpful but not always curative. The only way to prevent contracting this illness is through vaccination. Vaccination for pertussis is part of the DaPT vaccine. The pertussis vaccine is very important and life saving.

The recommended schedule for DaPT is two, four, and six-months of age with a booster dose at fifteen months and four years of age. The pertussis component of the vaccine does not need to be given after seven years of age, however, new research is showing that it may benefit society if older children and adults get booster doses with the Td (tetanus/diphtheria) every ten years.

ONE DOCTOR’S OPINION:

Now that the acellular vaccine is readily available, there is no reason not to vaccinate. This is a harsh, difficult, and potentially devastating illness that no child should suffer through. It is so contagious that if vaccine rates don’t stay very high, the illness will hit a community with a vengeance. There are still over 3,000 cases a year in the USA.  We will only be able to prevent this through proper vaccination.

 

Written by Dr. Michael Bornstein, who has over 28 years of experience as a pediatrician. 

Disclaimer: The contents of this article, including text and images, are for informational purposes only and do not constitute a medical service. Always seek the advice of a physician or other qualified health professional for medical advice, diagnosis, and treatment.