Whooping cough (Pertussis) is highly contagious respiratory infection that is caused by a bacteria (Bordetella pertussis). The first outbreaks were described in the 16th Century. The bacteria, Bordetella pertussis was not isolated until 1906! There are an estimated 300,000 plus deaths annually from whooping cough (pertussis).
Pertussis is whooping cough's medical name. It is the "P" in the DPT vaccine for children. Pertussis commonly affects infants and young children, but can be prevented with immunization with the vaccine. Immunity from DPT wears off, so many teenagers and adults get pertussis, first as coughing spasms and then a stubborn dry cough lasting up to 6-8 weeks.
Treatment of pertussis is supportive and many young infants need hospitalization if the coughing becomes severe. Immunization with DPT (diphtheria-pertussis-tetanus) vaccine provides protection.
With pertussis, an ounce of prevention is worth a pound of cure (or, if you are metrically inclined, a gram of prevention is worth a kilo of cure). Have your child immunized!
The first stage (catarrhal) of pertussis is characterized by the insidious onset of the following;
- runny nose
- low-grade fever
- mild, occasional cough, similar to the common cold
- the cough gradually becomes more severe, and after one to two weeks, the second stage (paroxysmal) begins.
It is during the second stage (paroxysmal) that the diagnosis of pertussis is usually suspected. The second stage is characterized by the following:
- Bursts, or numerous rapid coughs, apparently due to difficulty expelling thick mucus from the tracheobronchial tree.
- At the end of the bursts of rapid coughs, a long inspiratory effort is usually accompanied by a characteristic high-pitched whoop.
- During an attack, the individual may become cyanotic (turn blue).
- Children and young infants, especially, appear very ill and distressed.
- Vomiting and exhaustion commonly follow the episode.
- The person usually appears normal between attacks.
- Paroxysmal attacks occur more frequently at night, with an average of 15-24 attacks per 24 hours.
- The paroxysmal stage usually lasts 1 to 6 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.
In the convalescent stage, recovery is gradual. The cough becomes less paroxysmal and disappears over 2 to 3 weeks. However, paroxysms often recur with subsequent respiratory infections for many months after the onset of pertussis.
Pertussis in adults
Pertussis in adults accounts for up to 7% of cough illnesses per year. The disease is often milder than in infants and children. Adults are often the source of infection for children.
Complications of pertussis
Young infants are at the highest risk for pertussis, and for pertussis-associated complications. The most common complication, and the cause of most pertussis-related deaths, is secondary bacterial pneumonia. Data from 1997-2000 indicate that pneumonia occurred among 5.2% of all reported pertussis cases, and among 11.8% of infants less than six months of age.
For immunization information on pertussis for children, adolescents, and adults, please visit the following areas:
- Immunizations (Vaccination) for Adolescents and Adults
- Immunizations (Vaccinations) for Infants and Children
Some of the above information has ben provided with the kind permission of the Centers for Disease Control (www.cdc.gov).
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Last Editorial Review: 7/7/2004