Whooping Cough: Treatment and Prevention

Characterised by severe coughing spells that end in a "whooping" sound when the person inhales, pertussis, more commonly known as whooping cough, is a highly contagious and deadly respiratory infection.

Whooping cough is an acute​, infectious disease of the respiratory tract, caused by the bacillus Bordetella pertussis that lives in the human throat. Whooping cough is worldwide in distribution and sometimes occurs in epidemics. Most cases occur in children under five years of age, with children less than one year old being the most seriously affected.​ 

A vaccination exists for pertussis prevention. Through routine childhood immunisation programmes in most countries, the number of deaths from whooping cough has dropped significantly.

Whooping cough has three stages: the catarrhal, paroxysmal, and convalescent phase. Time from exposure to the first phase is seven to 14 days. The paroxysmal phase may last from one to several weeks. Antibiotics are an effective pertussis treatment method in the catarrhal phase and for secondary infection in the second phase.

The typical whoop is from a sharp inhalation at the end of a series of coughs. This may not be present in adults as their airways are wider.

Whooping Cough Causes and Risk Factors

Infection is transmitted by direct contact with the pertussis bacteria, usually by means of droplets sprayed into the air while coughing. The greatest risk of spread is during the early stage when it appears to be a cold.

Outbreaks of whooping cough may occur in teenagers and adults whose immunity against the bacteria from past vaccination has worn off and in infants six months of age and below, who have not received the full vaccination dose (at least three shots).

Whooping Cough Symptoms

Symptoms start between an average of seven to 10 days after exposure to the bacteria. Whooping cough can seem at first like an ordinary cold (runny nose, sneezing, cough, fever) for one to two weeks but tends to worsen with periods of uncontrolled coughing that can last up to two months. 

An infected individual has cough episodes that may lead to vomiting or a "whoop" sound when he tries to breathe in. These episodes frequently cause the child to go blue and can be very worrying for the onlooker. Between the periods of coughing spasms, the child may seem totally fine.

Adults may still contract whooping cough symptoms as pertussis prevention from immunisation only lasts five to 10 years after the last dose. When adults get whooping cough, the diagnosis may not be clear cut and it may present as a prolonged, irritating cough.

Sometimes the coughing may be so severe that it causes vomiting, nosebleeds or broken blood vessels in the whites of the eyes.

Complications of Pertussis

At the severe coughing stage, pneumonia​, seizures, brain damage, or even death may occur, especially in an infant. Serious complications are less likely with older children or adults.

Pertussis Treatment

Antibiotics (erythromycin) are often not as effective once severe whooping cough has developed. Hence, early antibiotic treatment is important and helps to reduce the illness term and prevents the spread of whooping cough to others. It should be given to family members once there is an infected person in the family.

Self-care for Whooping Cough

Here are some everyday ways to help encourage recovery:
Placing a humidifier in the bedroom
Reducing or avoiding triggers for coughing bouts (e.g. smoking in the home, dust, drafts, dry air, sudden changes in temperature)
Talking to a doctor or health professional about the use of cough medications

Pertussis Prevention

Since whooping cough can be fatal, vaccination is very important. Vaccination against diphtheria, pertussis (whooping cough), tetanus and Hib (haemophilus influenzae type B) is combined into one injection called "DPT/HIB". This vaccination is usually given to a baby at three months of age and repeated at four and five months of age.

Along with a booster at 18 months, this series of vaccinations usually prevents whooping cough. In rare cases, however, whooping cough may still occur despite receiving the vaccinations, if full immunity has not developed. The symptoms of whooping cough in these cases, however, are generally much milder.

Vaccination against diphtheria, tetanus and whooping cough may cause side effects like fever, tenderness, redness and swelling in the area where the child was injected. These symptoms may last one to two days. 

In very rare cases (one in 100,000 cases), serious reactions to the whooping cough part of the vaccination may occur, especially if your child has a history of seizures, a past reaction to the vaccine or a fever before the vaccine is given. This has caused some concern among parents who, in some countries, have stopped vaccinating their children against pertussis, thereby increasing their chances of catching or dying from whooping cough. Recently, an improved acellular pertussis vaccine was made available, offering lower risk of side effects from fever and seizures.

Whooping Cough: Treatment and Prevention

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