Whooping Cough
(Pertussis)
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Jay W. Marks, MD
What is whooping cough?
Whooping cough (pertussis) is an acute, highly contagious respiratory infection that is caused by a bacterium. The first outbreaks of pertussis were described in the 16th century. The bacterium responsible for the infection,
Bordetella pertussis, was not isolated until 1906. The incidence of pertussis has been steadily increasing since the 1980s. According to the U.S. Centers for Disease Control and Prevention (CDC), a total of 25,827 cases of pertussis were reported in 2004 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
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 second stage is
characterized by
- 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 posttussive
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.
Next: How is whooping cough transmitted? »
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