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Pertussis

(Whooping Cough )

Definition

Pertussis is a bacterial infection. It is also called whooping cough. The bacteria invade the lining of the respiratory tract and may block your airways.

Pertussis is highly contagious, and in some cases, very serious. Pertussis is treated with antibiotics.

Upper Respiratory Tract

Normal Upper Airway During Sleep
Copyright © Nucleus Medical Media, Inc.

Causes    TOP

Pertussis is caused by specific bacteria. It is spread by:

  • Inhaling droplets from the sneeze or cough of a person infected with pertussis
  • Having direct contact with the mucus of a person infected with pertussis

Risk Factors    TOP

Factors that may increase your chances of getting pertussis include:

  • Not being immunized
  • Living in the same house or working in close contact with someone infected with pertussis

Symptoms    TOP

Symptoms usually begin within a week or two after exposure.

Initial symptoms last about 1-2 weeks. They may include:

  • Runny nose and congestion
  • Sneezing
  • Mild fever
  • Mild cough
  • Watery, red eyes

The second stage of pertussis is called the paroxysmal stage. This stage usually lasts 1-6 weeks, but can last much longer. Symptoms may include:

  • Severe coughing
  • Long episodes of coughing that start suddenly and may end with a forceful inhale or 'whoop' (the whoop does not occur in all people)
  • In severe cases, coughing may cause a person to have trouble breathing or turn blue from lack of oxygen
  • Coughing episodes may result in vomiting

During the final stage, the cough gradually gets better over 2-3 weeks. Episodes of coughing can still occur during this stage.

Complications in infants and young children may include:

Complications in teens and adults can include weight loss and accidental urination. Rarely, fainting or rib fractures can occur from severe coughing.

Diagnosis    TOP

The doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:

  • Swab of nose and throat for culture and other tests to detect the bacteria
  • Blood tests

Treatment    TOP

Treatment may include:

Medication

Pertussis is treated with antibiotics, which keeps the infection from spreading. They are most effective when started in the early stages.

Treatment of Symptoms

Antibiotics or cough medicines do not prevent coughing. The following steps may help control symptoms and prevent complications:

  • Get plenty of rest
  • Use a cool mist vaporizer to loosen mucus and soothe the respiratory tract
  • Avoid irritants that trigger coughing, such as smoke or aerosol sprays
  • Drink plenty of fluids

Hospitalization    TOP

This may be necessary for those who develop severe infections. Patients are usually isolated to prevent spreading the disease to other people.

Prevention    TOP

Vaccine

The best way to prevent pertussis is immunization. All children (with few exceptions) should receive the DTaP vaccine series. This protects against diphtheria, tetanus, and pertussis. Another vaccine called Tdap is routinely given to children aged 11-12 after they have completed the DTaP series of shots. There are also catch-up schedules for children and adults who have not been fully vaccinated.

Pregnant women should have a dose of Tdap during every pregnancy to protect newborns from pertussis.

Preventive Antibiotics

People in close contact with someone infected with pertussis may be advised to take preventive antibiotics, even if they've been vaccinated. This is especially important in households with members at high risk for severe disease, such as children under one year of age or people with weak immune systems.

RESOURCES:

American Academy of Pediatrics
http://www.healthychildren.org
Center for Disease Control and Prevention
http://www.cdc.gov

CANADIAN RESOURCES:

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

References:

Immunization schedules. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/index.html. Updated January 29, 2013. Accessed June 5, 2013.
Pertussis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated February 25, 2013. Accessed June 5, 2013.
Pertussis. PEMSoft at EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Accessed June 5, 2013.
Pertussis (whooping cough). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/pertussis. Updated May 7, 2013. Accessed June 5, 2013.
Tdap vaccine. What you need to know Centers for Disease control and Prevention Website. Available at: http://www.cdc.gov/vaccines/hcp/vis/vis-statements/tdap.pdf. Accessed June 5, 2013.
Last reviewed December 2013 by David L Horn, MD, FACP
Last Updated: 1/13/2014