Pertussis (whooping cough)

What is it?

Pertussis, also known as whooping cough, is a highly contagious bacterial infection that causes violent coughing. The coughing makes it hard to breathe and produces a deep "whooping" sound.

Pertussis is caused by the Bordetella pertussis or Bordetella parapertussis bacteria. Droplets of the bacteria move through the air when an infected person sneezes, coughs or talks. This is how pertussis spreads from person to person.

Pertussis can occur at any age. Serious illness is most common in infants and young children. Older children, adolescents and adults usually have milder symptoms.

The number of pertussis cases in the United States has increased in recent years.

Symptoms

On average, symptoms begin about 7 to 10 days after the pertussis bacteria enter your body. Initial symptoms usually resemble the common cold. Other symptoms may include:

• low-grade fever
• sneezing
• runny nose
• diarrhea
• vomiting
• thick, clear discharge from the nose
• episodes of rapid coughing followed by a high-pitched whooping sound
• frequent coughing episodes at night
• recurring coughing episodes for one to two months.

Infants under 6 months of age, adolescents and adults may have a cough that lasts many weeks without the characteristic whooping sound. If you have a cough that lasts more than a week without improvement, contact your doctor.

Diagnosis

Your doctor will ask about your symptoms and examine you. However, the examination is often not remarkable. Most people with pertussis don't have fever by the time they see the doctor.

Your doctor will suspect the diagnosis based on:

• The pattern of your symptoms. Typically, the initial symptoms are nasal congestion, sneezing, cough, tearing and perhaps a low-grade fever. The cough may be mild at first and become more prominent later on.
• Whether you live in an area that has had a recent outbreak of pertussis.
• Whether you've had any contact with whooping cough.

If your doctor thinks you have pertussis, a swab from your nose or throat can confirm the diagnosis.

Prevention

A vaccine is available for both children and adults. Children up to age 7 years old receive an immunization called DTaP, which includes pertussis, diphtheria and tetanus vaccines. Babies under 6 weeks old cannot receive DTaP.

Doctors recommend 5 total doses of the DTaP vaccine for all infants and children, unless there is a medical reason to withhold vaccination. Children are usually immunized at ages 2 months, 4 months, 6 months, 15 to 18 months and 4 to 6 years.

Vaccines are also available for older children and adults. These age groups receive a pertussis vaccine called Tdap. This should be given at age 11 or 12 and every 10 years thereafter.

If you live with or have close contact with someone who has pertussis, contact your doctor to ask whether you should take an antibiotic.

If you have whooping cough, avoid contact with infants, young children and pregnant women.

All pregnant women should be vaccinated against pertussis. Even if you have been vaccinated within the prior couple years before pregnancy, your doctor may recommend you receive it again to protect your newborn. Also be sure everyone in your household is up-to-date with Tdap vaccine.

Treatment

If you have whooping cough, your doctor will prescribe antibiotics. Antibiotics are most effective in the early stages of the infection. You will no longer be contagious after about five days of antibiotics. However, your cough may continue for weeks even if you have taken antibiotics.

When to call a professional

Call your doctor if you or your child has a prolonged cough or develops other symptoms of pertussis.

Call 911 or go to an emergency room if you or your child has any of the following symptoms:

• bluish skin color (this may indicate a lack of oxygen)
• difficulty breathing
• convulsions or seizures
• high fever
• persistent vomiting.

Prognosis

In older children and adults, the outlook is generally very good. It may take a few months for the cough to entirely clear up. Infants need careful monitoring to avoid complications.

Additional info

Centers for Disease Control and Prevention (CDC)
https://www.cdc.gov/