Whooping Cough

(Pertussis)

by Rick Alan

Definition

Whooping cough is a bacterial infection of the respiratory tract. The bacteria invade the lining of the respiratory tract and airways. This causes inflammation and increased mucus. It is very contagious. It can be serious.

Upper Respiratory Tract

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

Causes

Whooping cough is caused by the bacterium Bordetella pertussis. It is spread by:

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

Risk Factors    TOP

Risk factors that increase your chance of getting whooping cough include:

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

Symptoms    TOP

Symptoms usually begin 1-2 weeks (at most, three weeks) after exposure to the bacterium.

Initial symptoms last about 7-14 days. They include:

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

The second stage of whooping cough is called the paroxysmal stage. This stage usually lasts 1-6 weeks but can last much longer. Symptoms 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

Antibiotics, such as erythromycin, clarithromycin, or azithromycin are used. They are most effective when started in the early stages.

Treatment of Symptoms

To help reduce vomiting and reduce the chance of dehydration:

  • Eat small, frequent meals.
  • Drink plenty of fluids. For older children and adults, water, unsweetened fruit juices, and clear soup may be good options.

Hospitalization

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

Prevention    TOP

Vaccine

The best way to prevent whooping cough 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.

Preventive Antibiotics

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

RESOURCES:

American Medical Association
http://www.ama-assn.org/
Center for Disease Control and Prevention
http://www.cdc.gov/

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca
Healthy U
http://www.healthyalberta.com/

References:

Kleigman RM, Behrman RE, Jenson HB, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia PA: Saunders; 2007.
Pertussis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated September 21, 2012. Accessed December 4, 2012.
Pertussis (whooping cough). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/pertussis/about/index.html . Updated November 1, 2012. Accessed December 4, 2012.
Recommended adult immunization schedule—United States, 2012. MMWR Morb Mortal Wkly Rep . 2012;6(4). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov... . Accessed December 4, 2012.
Recommended immunization schedule for persons aged 0 through 6 years—United States 2012. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov... . Accessed December 4, 2012.
Recommended immunization schedule for persons aged 7 through 18 years—United States 2012. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov... . Accessed December 4, 2012.
Tetanus, diphtheria (Td) or tetanus, diphtheria, pertussis (Tdap) vaccine: what you need to know. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-td-tdap.pdf . Published January 24, 2012. Accessed December 4, 2012.
1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR. 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm . Updated January 10, 2008. Accessed January 28, 2008.
1/24/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (tdap) vaccine from the advisory committee on immunization practices, 2010. MMWR Morb Mortal Wkly Rep. 2011;60(1):13-15.
11/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) in pregnant women and persons who have or anticipate having close contact with an infant aged <12 months—Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep. 2011;60:1424-1426.
Last reviewed November 2012 by Brian Randall, MD
Last Updated: 11/26/2012