Whooping cough (pertussis)

Whooping cough is a respiratory infection that can cause serious symptoms in young children. The video shows a young child who has coughing fits and breathing difficulties which are typical for this disease. This is a unique video and we recommend that all parents watch it.

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What is whooping cough?

Whooping cough is an infection of the respiratory tract, which can cause severe symptoms, especially in unvaccinated newborns and young infants.

The disease usually appears in older children and adults as a simple cold with coughing and maybe a little fever.

The cough can seem more like an irritable cough, which can be a problem day and night that can become persistent.

Whooping cough is caused by the bacterium Bordetella pertussis and is very contagious.

The infection is carried by saliva and mucus from the nose, spreading through sneezing, coughing and direct contact with the infected secretions.

The incubation period (the time between infection and the onset of symptoms) lasts 5 to 21 days, usually for about a week.

The infection can be spread to others, especially if antibiotic treatment is not started.

Symptoms

Symptoms and signs

The disease starts as an infection of the upper respiratory tract with cold-like symptoms in the form of a head cold, mild fever and mild coughing (the catarrhal stage).

Following the onset of symptoms in the first week or two, the cough becomes more pronounced and the child has coughing fits (the coughing stage), i.e. bursts of coughing, especially at night.

Between coughing fits the child takes in gasps of air accompanied by the characteristic noise – a “whooping” sound – hence the name whooping cough. 

Young children can experience great discomfort during these coughing fits. They often whoop before vomiting and their skin color often turns bluish as a result of the temporary lack of oxygen.

Between the coughing fits, the child may appear to be in good general health. The coughing stage can last 2 to 4 weeks before the symptoms gradually improve.

Some infants can experience temporary loss of breath instead of coughing fits. The cough can also last many weeks and has been referred to as the “100 day cough”.

Complications

Complications

Young infants in their first year of life are most likely to have problems if they get whooping cough.

They are not fully vaccinated against whooping cough and may become very ill. They run the risk of getting pneumonia and may need extra oxygen during the coughing spells.

Moreover, the child may suffer because they don’t eat or drink enough, as the coughing fits are often accompanied by vomiting.

Look out for danger signs of dehydration, i.e. increased thirst, dry lips and lining of the mouth, sunken eyes, dry skin, and, less often, urination, tiredness and irritability.

Children under 6 months may even need to be hospitalized.

In very rare cases, whooping cough can cause seizures and brain damage in newborns and infants. The child will be isolated at the hospital so that he does not pass this infection on to others.

Besides the antibiotic treatment, it may often be necessary to give extra oxygen, suction mucus from the respiratory tract, and give intravenous (directly into a vein) fluids.

Home treatment

Treatment / What you should do

You should consult a physician if you suspect that your child has whooping cough.

The cough can be diagnosed by taking a mucus swab from the nose or with a blood test.

Whooping cough is usually treated with antibiotics for up to 2 weeks.

Your physician will also consider treating those near you, especially those who have cold-like symptoms and have not been fully vaccinated. The risk of infection is considered to be over once 5 days has passed from the start of the antibiotic treatment.

In addition to an antibiotic, the child should receive soothing treatment by being given plenty of fluids and, when appropriate, nose drops.

Cough syrups are rarely effective, but a cool-mist vaporizer can often ease the child's discomfort.

Make sure that the child is not exposed to aerosol sprays, tobacco smoke and other substances, which can irritate the respiratory passages.

In addition, make sure that the child does not become dehydrated. Allow the child to have smaller, but more frequent meals.

Prevention

Prevention

Vaccination is the best way to prevent pertussis.

In the U.S. the whooping cough vaccine is administered as part of the Recommended Childhood Immunization Schedule.

Children should be vaccinated against diphtheria, tetanus and pertussis (DTaP) at 2, 4, 6 and 15 to 18 months of age, 4 to 6 years of age. Teens beginning at 11-12 years of age and adults can also receive a whooping cough vaccine called Tdap.

The effect of the whooping cough vaccine weakens as years go by, so the protection may be less effective after 5 years or so.

If some cases of confirmed whooping cough have been identified in your community, you should try to protect any unvaccinated infant from infection, and teenagers and adults may require re-vaccination.

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