Understanding Whooping Cough (Pertussis)
Whooping cough (pertussis) is a bacterial infection of the respiratory tract. It is highly contagious and spreads easily from person to person through droplets when an infected person coughs, sneezes, or talks. With whooping cough, thick mucus forms deep inside the airways. This leads to severe coughing spells that produce a “whooping” sound (sharp intake of breath). Most infants and children in the U.S. get a series of vaccines to prevent whooping cough. But infants too young to be fully immunized are vulnerable to infection. Occasionally, whooping cough can occur in children who have had the full series of vaccines. Protection from the vaccine or the disease will also wear off over time, leaving older children, adolescents, and adults at risk.
What are the symptoms?
At first, whooping cough seems like a common cold. Symptoms include a runny nose, sneezing, mild fever, and a slight cough.
One to 2 weeks later, the cough becomes severe. It usually comes in spells that last a minute or more and end with a high-pitched whoop. The intense coughing can cause a child to break a rib, vomit, turn blue, or even pass out. This stage can last 1 to 6 weeks or longer.
In time, the cough improves, although it may linger in a less severe form for months. A child can spread the infection as long as the cough lasts.
What are the complications of whooping cough?
Whooping cough can cause other problems including:
Slowed or stopped breathing
Infants and young children less than 2 years old are more at risk for serious problems and even death.
Who is at risk?
Children who have all of the vaccines are usually protected from whooping cough. But others are at risk, including:
Infants 6 months and younger who haven’t received at least 3 doses of whooping cough vaccine
Children and teens age 11 to 18 who haven’t had a booster shot of the vaccine
Anyone who hasn’t been vaccinated or who hasn’t had a booster shot of the vaccine
How is whooping cough diagnosed?
Your child’s healthcare provider will ask about your child’s health history and do a physical exam. A small sample of material may be taken from your child’s nose or throat. The sample is sent to a lab and tested for the bacteria that cause whooping cough. Your child may also have blood tests or chest X-rays.
How is whooping cough treated?
Older children and teens are usually treated at home with self care to keep them comfortable until the symptoms pass. Infants and toddlers are more likely to have complications, so they are often treated in the hospital. During a hospital stay, children with whooping cough:
May be given medicines to relieve inflamed airways
Have their breathing carefully monitored
May have their airways suctioned to remove mucus
Receive antibiotics through an IV line (soft tube into a vein in the arm)
If antibiotics are prescribed
Antibiotics won’t cure whooping cough in most cases. But they may be prescribed to help make your child less contagious. In that case:
Make sure your child takes ALL the medicine, even if he or she feels better. Otherwise, the infection may come back.
Be sure your child takes the medicine as directed. For example, some antibiotics should be taken with food.
Ask your child’s healthcare provider or pharmacist what side effects the medicine may cause and what to do about them.
Your child should stay home from school until he or she has completed at least 5 days of antibiotic treatment. If appropriate antibiotic treatment is not used, he or she should wait 3 weeks or 21 days after the onset of the cough.
Caring for your child at home
To help your child recover fully from whooping cough:
Provide plenty of fluids, such as water, juice, or warm soup. Fluids help loosen mucus, so your child can breathe more easily. They also help prevent dehydration.
Offer smaller meals. Small amounts of food are easier to eat when coughing is severe.
Make sure your child gets enough rest. Ask your child’s healthcare provider about the best position to improve breathing.
Run a humidifier in your child’s bedroom to relieve coughing and loosen mucus in the airways. Be sure to clean the humidifier regularly to prevent growth of mold and bacteria.
Keep your house free of irritants that can trigger coughing spells. These include tobacco smoke and fumes from fireplaces.
Avoid giving your child over-the-counter cough syrups. They won’t ease your child’s cough and may be harmful.
Don’t take your child with whooping cough to school or daycare until the healthcare provider says it’s OK.
Ask your child’s healthcare provider if others in your household should get a booster shot to help keep them from getting sick.
When to call your healthcare provider
Call your child’s healthcare provider right away if your child:
Turns blue or has trouble breathing
Exhaustion after coughing spells
Loss of appetite and eating poorly
Vomiting after coughing spells
Weak and looking sick
Develops a fever 100.4° F (38.0°C) or higher in an infant under 3 months of age
Has a fever that repeatedly rises to 104°F (40°C)
A fever that lasts more than 24 hours in a child under 2 years old or for 3 days in a child 2 years or older.
Has signs of dehydration such as sunken eyes, dry mouth, dark or strong-smelling urine, or no urine output in 6 to 8 hours
Preventing whooping cough
Most children receive a vaccine against whooping cough starting at 2 months of age. It’s often combined with vaccines for 2 other diseases, diphtheria and tetanus. The combination vaccine (called DTaP) is given in a series of 5 shots at these ages:
15 to 18 months
4 to 6 years, just before starting school
Make sure your child has the full series of whooping cough vaccines. If your child misses a shot, talk to your child’s healthcare provider about a makeup schedule. Effects of the vaccine may start to fade by age 11. For that reason, doctors recommend a booster shot for most children at 11 to 12 years of age. Booster shots are also recommended for some adults. Talk to your child’s healthcare provider to learn more. And make sure to avoid being around adults or children with whooping cough.
February 10, 2018
Pertussis infection in infants and children: Clinical features and diagnosis, Up To Date
Fetterman, Anne, RN, BSN,Images Reviewed by Staywell medical art team.,Lentnek, Arnold, MD