Pertussis (Whooping Cough)
What is Pertussis (Whooping Cough)?
Pertussis, commonly known as "whooping cough," is an infection of the respiratory tract caused by the Bordetella pertussis bacteria. This infection is very contagious and can be quite serious. It affects the respiratory system and produces spasms of coughing that usually end in a high-pitched sound with deep inspiration (the whoop). People become infected with the bacteria by inhaling contaminated droplets from an infected person's cough or sneeze. Once inside the airways, pertussis bacteria produce chemical substances or toxins that interfere with the respiratory tract's normal ability to eliminate germs. Pertussis bacteria also produce chemicals that cause inflammation that damage the lining of the breathing passages.
What are the symptoms?
Once an unimmunised child has been infected, it usually takes three days to 21 days for symptoms to develop. The first symptoms of pertussis may be similar to those of a common cold, including nasal congestion, runny nose, sneezing, red and watery eyes, mild fever, and a dry cough. After about one to 2 weeks, the dry cough becomes a wet cough that brings up thick, stringy mucus. At the same time, coughing begins to occur in long spells that may last for over a minute, sometimes causing a child to turn red from effort or blue from lack of oxygen. At the end of a coughing spell, the child gasps for air with a characteristic "whooping" sound. Infants may not whoop at all or as loudly as older children. Severe coughing can lead to vomiting and may make it hard for a child to eat or drink. Severe coughing can also cause tiny, red spots caused by ruptures in blood vessels at the skin's surface, as well as small areas of bleeding in the white of the eyes. Coughing spells can continue for several weeks.
How is the diagnosis made?
The doctor can confirm pertussis by taking a sample of secretions from the nose or throat and identifying the pertussis bacteria in the secretions. Blood tests and a chest X-ray may also be done.
What is the treatment?
Pertussis is treated with antibiotics, usually erythromycin. Some experts believe that treatment is most effective when antibiotics are started early in the course of the illness. Antibiotics are also very important in stopping the spread of pertussis bacteria from the infected child to other people. Ask the doctor's advice about the need for giving prophylactic preventive antibiotics or vaccine boosters to others in the household. The pertussis cough can cause the child to vomit, losing nutrients that he needs to recover his strength. To help decrease the chance of vomiting, give frequent meals with small portions. Encourage the child to drink water, fruit juice, and clear soups to prevent dehydration. In some cases, a child with pertussis may need treatment in a hospital. Almost all infants with pertussis who are less than six months old receive hospital treatment for their illness, and about 40 percent of older babies with pertussis are also hospitalized. Many of these children have pneumonia associated with this infection. Other possible complications of pertussis include ear infection, and seizures. While in the hospital the child will be isolated from other patients.
What are the prevention?
Pertussis can be prevented by the pertussis vaccine, which is part of the DTaP (diphtheria, tetanus, acellular pertussis) or DTP immunizations. These important immunizations are routinely given in five doses before a child's sixth birthday. The pertussis vaccine has dramatically decreased the number of cases of whooping cough that occur and saved countless lives. Preventive oral antibiotics should be given to anyone who lives in the same household as someone with pertussis.