Whooping Cough (Pertussis) Symptoms, Causes, Diagnosis, Treatment and Prevention by MedicineNet.com

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Whooping Cough
(Pertussis)

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Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Jay W. Marks, MD

Featured patient discussions on whooping cough

"I had whooping cough five years ago in my late 40s. The cough persisted for more than three months; in between coughing attacks, I felt perfectly well. The coughing was always much worse at night, and I had to sleep partially sitting up. I was aware of rustling, crackling sounds in my chest as I breathed, particularly at night. The sensation of being unable to stop coughing was very distressing, with each coughing bout I feared I would choke. I felt very anxious and also depressed during this time because of it. Eventually, the spasms became less and finally ceased. I asked my doctor if I would be likely to get it again, or should be vaccinated against it, and he did not know. Currently, after having mild cold symptoms a few weeks ago which seemed to linger, I have started to have small coughing spasms, particularly at night, and am fearful that I have caught it again. I was vaccinated against whooping cough as a child, and the diagnosis of whooping cough five years ago was eventually confirmed by blood tests. I dread having the same experience again; being unable to stop violently coughing made me feel very fearful."

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What is whooping cough? What is the history of whooping cough?

Whooping cough (pertussis) is an acute, highly contagious respiratory infection that is caused by a bacterium. The term whoop originates from the inflammation and swelling of the laryngeal structures that vibrate when there is a rapid inflow of air during inspiration. The first outbreaks of whooping cough were described in the 16th century. The bacterium responsible for the infection, Bordetella pertussis, was not identified until 1906. The incidence of whooping cough has increased since the 1980s, with epidemics occurring every three to five years in the U.S. In the last epidemic which occurred in 2005, 25,616 cases were reported according to the U.S. Centers for Disease Control and Prevention (CDC). In 2007, a total of 10,454 cases of whooping cough were reported in the U.S.

Can whooping cough be prevented with a vaccine?

Whooping cough commonly affects infants and young children but can be prevented by immunization with pertussis vaccine. Pertussis vaccine is most commonly given in combination with the vaccines for diphtheria and tetanus. (Pertussis is the "P" in the DTaP combination inoculation routinely given to children, and the "p" in the Tdap vaccine administered to adolescents and adults.) Since immunity from the pertussis vaccine wears off with time, many teenagers and adults get whooping cough.

What are the stages, symptoms, and signs of whooping cough?

The first stage of whooping cough is known as the catarrhal stage. In the catarrhal stage, which typically lasts from one to two weeks, an infected person has symptoms characteristic of an upper respiratory infection, including

runny nose,
sneezing,
low-grade fever, or a
mild, occasional cough, similar to the common cold.

The cough gradually becomes more severe, and after one to two weeks, the second stage begins. It is during the second stage (the paroxysmal stage) that the diagnosis of whooping cough usually is suspected. The following characteristics describe the second stage:

Bursts (paroxysms) of coughing, or numerous rapid coughs, are apparently due to difficulty expelling thick mucus from the airways in the lungs. Bursts of coughing increase in frequency during the first one to two weeks, remain constant for two to three weeks, and then gradually begin to decrease in frequency.

At the end of the bursts of rapid coughs, a long inspiratory effort (breathing in) is usually accompanied by a characteristic high-pitched "whoop."

During an attack, the individual may become cyanotic (turn blue) from lack of oxygen.

Children and young infants appear especially ill and distressed.

Vomiting (referred to by doctors as post-tussive vomiting) and exhaustion commonly follow the episodes of coughing.

The person usually appears normal between episodes.

Paroxysmal attacks occur more frequently at night, with an average of 15-24 attacks per 24 hours.

The paroxysmal stage usually lasts from one to six weeks but may persist for up to 10 weeks.

Infants under 6 months of age may not have the strength to have a whoop, but they do have paroxysms of coughing.

The third stage of whooping cough is the recovery or convalescent stage. In the convalescent stage, recovery is gradual. The cough becomes less paroxysmal and usually disappears over two to three weeks; however, paroxysms often recur with subsequent respiratory infections for many months.