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Whooping Cough

Whooping cough (pertussis) is a very contagious disease found only in humans.  People with pertussis usually spread the disease by coughing or sneezing while in close contact with others, who then breathe in the pertussis bacteria. Many infants who get pertussis are infected by older siblings, parents or caregivers who might not even know they have the disease.

Symptoms

Symptoms of pertussis usually develop within seven to ten days after being exposed, but sometimes not for as long as six weeks.  The disease usually starts with cold-like symptoms and there may be a mild cough or fever. After one to two weeks, severe coughing can begin. Unlike the common cold, pertussis can become a series of coughing fits that continues for weeks.

In infants, the cough can be minimal or not even there. Infants may have a symptom known as "apnea." Apnea is a pause in the child’s breathing pattern. Pertussis is most dangerous for babies. More than half of infants younger than one year of age who get the disease must be hospitalized.

Pertussis can cause violent and rapid coughing, over and over, until the air is gone from the lungs and you are forced to inhale with a loud "whooping" sound. This extreme coughing can cause you to throw up and be very tired. The "whoop" is often not present and the infection is generally milder (less severe) in teens and adults who have been vaccinated.

Early symptoms of pertussis can last for one to two weeks and usually include:

Because pertussis, in its early stages, appears to be nothing more than the common cold, it is often not suspected or diagnosed until more severe symptoms appear. Infected people are most contagious during this time, up to about two weeks after the cough begins. Antibiotics may shorten the amount of time someone is contagious.

As the disease progresses, the traditional symptoms of pertussis appear and include:

The coughing fits can go on for up to ten weeks or more. Although you are often exhausted after a coughing fit, you usually appear fairly well in-between. Coughing fits generally become more common and severe as the illness continues, and can occur more often at night.

Treatment

Pertussis is generally treated with antibiotics and early treatment is very important. Treatment may make your infection less severe if it is started early, before coughing fits begin. Treatment can also help prevent spreading the disease to others. Treatment after three weeks of illness is unlikely to help because the bacteria are gone from your body, even though you usually still have symptoms. This is because the bacteria have already done damage to your body.

There are several antibiotics available to treat pertussis. If you or your child is diagnosed with pertussis, your doctor will explain how to treat the infection.

Recovery from pertussis can happen slowly. The cough becomes less severe and less common. However, coughing fits can return with other respiratory infections for many months after pertussis started.

Prevention

The best way to prevent pertussis among infants, children, teens and adults is to get vaccinated. Also, keep infants and other people at high risk for pertussis complications away from infected people.

In the United States, the recommended pertussis vaccine for infants and children is called DTaP. This is a combination vaccine that protects against three diseases: diphtheria, tetanus and pertussis. For maximum protection against pertussis, children need five DTaP shots. The first three shots are given at two, four and six months of age. The fourth shot is given between 15 and 18 months of age, and a fifth shot is given before a child enters school, at four to six years of age. 

Vaccine protection for pertussis, tetanus and diphtheria fades with time. Before 2005, the only booster available contained protection against tetanus and diphtheria (called Td), and was recommended for teens and adults every ten years. Today, there are boosters for pre-teens, teens and adults that contain protection against tetanus, diphtheria and pertussis (Tdap). Pre-teens going to the doctor for their regular check-up at age 11 or 12 years should get a dose of Tdap. Teens who did not get this vaccine at the 11- or 12-year-old check-up should get vaccinated at their next visit. Adults who did not get Tdap as a pre-teen or teen should get one dose of Tdap instead of the Td booster.

Women of child-bearing age should receive the Tdap booster shot – ideally before becoming pregnant. If not already vaccinated with Tdap, new mothers should get vaccinated before leaving the hospital with a newborn. Those around the infant – parents, siblings, grandparents, other family members, and nannies – are encouraged to get the appropriate vaccine (either DTaP or Tdap depending on age).

Pertussis vaccines are very effective in protecting against disease but no vaccine is 100% effective. If pertussis is circulating in the community, there is a chance that a fully vaccinated person, of any age, can catch this very contagious disease. If you have been vaccinated, the infection is usually less severe. If you or your child develops a cold that includes a severe cough or a cough that lasts for a long time, it may be pertussis. The best way to know is to contact your doctor.

Source:

 Centers for Disease Control, http://www.cdc.gov/pertussis/about/causes-transmission.html

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