Whooping cough is caused by a bacterium called Bordetella Pertussis which is spread through the air when an infected person coughs. Whooping cough tends to spread more easily in “close-contact” situations such as among family members and in schools. The infection begins like a regular cold that lasts for about a week and then the very characteristic cough phase develops. The cough occurs in spurts during which a child’s face turns red, has teary eyes, and often vomits after the cough. There is a very characteristic” Whoop sound” during the cough giving the very scary impression of choking. This cough phase can last for up to 3 months and typically slowly goes away on its own. It can occur at any time of the day and usually is triggered by exercise. Although it causes great discomfort, Pertussis is not considered life-threatening in older children and adults. However, it can be very dangerous, even deadly in infants and young babies.
Making the diagnosis
Confirming Pertussis is often not easy. Sometimes the diagnosis can be made by a nasal swab test. However, even if the test is negative it does not rule out whooping cough. In most cases, the diagnosis is made based on the presence of the very characteristic cough episodes.
Treating whooping cough
Unfortunately, antibiotics do not usually change the duration of the symptoms. Antibiotics are generally given to individuals and close contact to stop the spread of the bacteria. The only available treatment is supportive including cough medicines (given only under the direct supervision of a physician). Of course, babies with whooping cough are hospitalized for very close monitoring, treatment, and support.
How is whooping cough prevented?
The Pertussis vaccine has been very helpful in preventing whooping cough over the last several decades. However, the older Pertussis vaccine was not 100% effective wore off with age, and had some potentially serious side effects. It was initially given 5 times, incorporated with the routine vaccines schedule with the last booster given between 4-6 years of age. A newer version has been developed, known as the Acellular Pertussis vaccine, which is now recommended to be given 6 times including the last dose (combined with the diphtheria-tetanus vaccine) during the teenage years. In fact, adults now also need 1 extra booster dose. See your doctor for more details.
To conclude, whooping cough is still around. Older people whose immunity wears off can get infected, generally with mild symptoms, but can spread the bacteria to babies and young children who have not yet been fully vaccinated. Administering a booster dose of the Acellular Pertussis vaccine to teenagers and to adults may surely help prevent it in this age group. Your healthcare provider can give you more details as to who in your family needs a booster shot.
A SPECIAL NOTE FOR PREGNANT MOTHERS(ADDED JUNE 2018):
Recent American and Canadian guidelines recommend that all pregnant women receive the pertussis vaccine during every pregnancy even if they have previously received this vaccine. This is to prevent whooping cough infection in the mother, who might otherwise spread it (in many situations unknowingly) to her newborn baby. In addition, during pregnancy, the mother’s antibodies against whooping cough are transferred to the unborn baby and can protect the newborn for several months. If you are pregnant or planning to be, please speak to your healthcare provider for more details.
Pediatrician DR.PAUL Roumeliotis is certified by the American Board of Pediatrics and Royal College of Physicians and Surgeons of Canada. The information provided above is designed to be an educational aid only. It is not intended to replace the advice and care of your child’s physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition always consult a physician.