Whooping Cough Pertussis
What is it?
Whooping cough, also known as pertussis, is a highly contagious, potentially serious, bacterial infection of the respiratory tract. Symptoms occur in three distinct stages, each lasting several weeks. The disease may affect anyone, but it is most dangerous when severe coughing interferes with breathing in children and infants; pneumonia, seizures, and encephalopathy can be serious complications in young infants. Pertussis in older children and adults results in mild symptoms such as nasal congestion and cough. Fortunately, the incidence of whooping cough has declined sharply in the United States since the introduction of the pertussis vaccine in the 1940s. The vaccine does not provide indefinite immunity, but it protects children during the ages when they are most at risk.
What Causes It?
- An infection with the bacterium Bordetella pertussis causes whooping cough.
- Whooping cough is spread through the air by the sneeze or cough of an infected person. The infection may spread easily in families, schools, and day-care centers; those living in overcrowded or unsanitary conditions are at heightened risk. Infants younger than six months and those born prematurely are also at increased risk for the disease.
Prevention
- A combination vaccine that protects against diphtheria, tetanus, and pertussis, known as DTP, provides immunity from pertussis for a number of years. A new derivation of the vaccine, DTaP (acellular pertussis vaccine), is currently recommended and has fewer side effects of fever and redness at the injection site. Children should receive the DTaP vaccine at two, four, six, and 18 months of age. A DTaP booster shot is given between the ages of four and six years, just before the child starts school.
- A 14-day course of preventive antibiotics may be administered to household members or schoolmates if a child develops whooping cough. Children under seven years of age who are unimmunized or have received fewer than four doses of DTP or DTaP vaccine may be given a booster shot; younger children should be continued on their regular vaccination schedule.
Diagnosis
- Patient history and physical examination during the paroxysmal stage usually establishes the diagnosis.
- Throat culture.
- Chest x-ray if pneumonia is suspected.
How to Treat It
- Treatment with antibiotics during the first stage may limit or prevent more severe symptoms. Antibiotics administered during the second stage do not alter the course of the infection but can reduce the degree of contagion. Fourteen days of antibiotic therapy is recommended.
- Supportive care is aimed at making the patient as comfortable as possible. Plenty of fluids and frequent small meals are recommended.
- Hospitalization in an isolation room may be necessary for infants, especially those younger than six months of age.Oxygen and intravenous fluids and nutrients may be administered.
When to Call a Doctor
- Call a doctor if a child's cold persists or worsens.
- EMERGENCY Call an ambulance if a child turns blue or stops breathing.
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Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.