Pertussis (Whooping Cough)

Across the United States, we’ve seen an increasing number of Pertussis cases affecting both children and adults. Many areas across the US have seen a sharp rise in cases, including life-threating ones, that researchers have linked to, among other factors, unvaccinated children.

Pertussis, more commonly known as Whooping Cough, is a highly contagious bacterial infection caused by Bordetella pertussis. The infection is spread from person to person by respiratory secretions, most commonly coughing or sneezing. The incubation period is 7 to 14 days. If you’ve been exposed to the bacteria, you begin to see signs 1-2 weeks later.

Symptoms

Symptoms of Whooping Cough typically last anywhere from 6-10 weeks. A person is most contagious in the first 2-3 weeks.  Symptoms in the beginning are usually mild and resemble the common cold, including runny nose, nasal congestion sneezing, watery and or red eyes, dry cough, and possibly a mild fever. After 1-2 weeks, when a typical cold should be improving, the symptoms worsen. The nasal secretions become more thick, causing uncontrollable, prolonged coughing fits. These coughing fits happen at any time and can cause vomiting, result in the face turning red or even blue, and cause extreme tiredness. They end in what we refer to as a high pitched whooping sound — hence the name “whooping cough.”

The last stage of the disease may last for weeks. Although the patient begins to feel a bit better, the cough may actually worsen.  The cough can occur on and off for weeks or even months and can flare with any new viral illnesses the patient may contract. This stage may last longer in patients who have never had the pertussis vaccine.

Risks

Children who’ve been incompletely vaccinated (see “Prevention” below) and adults who have not received a booster vaccine are at an increased risk of having more severe symptoms and complications. Complications of the disease may include encephalopathy, pneumonia, dehydration, hospitalization, and, in very severe cases, death.

Diagnosis

Whooping cough is diagnosed by clinical exam and history, including any exposure the patient may be known to have had, or if there has been an influx of cases in the community. Samples of mucus from thenasopharynx, the area of the throat behind the nose, can be tested specifically for the B. pertussis bacteria. Blood tests and x-rays may be done to rule out other causes but will not specifically diagnose pertussis.

Treatment

Pertussis is treated with antibiotics primarily to reduce the spread of the infection and help shorten the illness.  Supportive care to help with the symptoms may include cool mist humidifier and over the counter cough medicines based on the age of the patient.  OTC cough  medicines are not recommended under the age of 6.  In certain situations it is recommended to use prophylactic antibiotics, antibiotics to help prevent the disease from developing, to people with a known exposure.  If you or your child have been exposed you should contact your physician to determine the need for medication.

Prevention

The best treatment for the disease is not treatment at all, but PREVENTION. The only way we can prevent the disease is to ensure that we and our children are properly immunized. Immunization against pertussis is given with the DTaP vaccine, starting at the age of 2 months. This vaccine is given at 2, 4, and 6 months, with boosters at 18 months and 4-5 years. A patient who has not completed the entire series is more at risk than someone who has received the complete series.

Researchers have recently found that immunity wanes over time. In other words, teens and adults are no longer as protected against the disease as they were when they were children. Therefore, it’s now recommended that all adults and teens receive a Tdap vaccine to boost their immunity.

As always, it’s very important to wash your hands frequently, and to not expose others to your illness if you are sick.

Questions?

If you have any questions or concerns about your child, or have not had your child or yourself vaccinated, please call us and/or your own health care provider. At Kids Plus, we encourage ALL children to be fully immunized, and we also offer the vaccine to our parents and caregivers.

Dr. Alicia Hartung, a shareholder in the practice, has been a Kids Plus Doc since 2001.