What is whooping cough (pertussis)?

Whooping cough, or pertussis, is very contagious and mainly affects infants and young children. Whooping cough is caused by a bacterium called Bordetella pertussis. The illness is characterized by coughing spells that end with a characteristic "whoop" as air is inhaled. Whooping cough caused thousands of deaths in the 1930s and 1940s. With the advent of a vaccine, the death rate has declined dramatically. Pertussis vaccines are very effective. However, if pertussis is circulating in the community, there is a possibility that even a fully vaccinated person could catch the disease. Babies who are too young to receive the vaccine are also at very high risk of catching pertussis. The illness can be very serious, even sometimes fatal, in young infants. Many babies infected with pertussis have caught it from an adult.

What are the symptoms of whooping cough?

The disease starts like the common cold, with a runny nose or congestion, sneezing, and sometimes a mild cough or fever. Usually, after a week or two, severe coughing begins. The following are the most common symptoms of whooping cough. However, each person may experience symptoms differently. Infants younger than age 6 months may not have a classic whooping cough, or it may be difficult to hear. Instead of coughing, infants may have a pause in their breathing, called apnea, which is very serious. You should consult your health care provider or call 911 if you observe pauses in breathing. Symptoms of whooping cough may include:

• Coughing, violently and rapidly, until all the air has left the lungs and a person is forced to inhale, causing a "whooping" sound

• Sneezing

• Nasal discharge

• Fever

• Sore, watery eyes

• Lips, tongue, and nailbeds may turn blue during coughing spells

Whooping cough can last up to 10 weeks and can lead to pneumonia and other complications.

The symptoms of whooping cough may look like other medical conditions. Always consult your health care provider for a diagnosis.

How is whooping cough diagnosed?

In addition to a complete medical history and physical exam, diagnosis of whooping cough is often confirmed with a culture taken from the nose.

What is the treatment for whooping cough?

Specific treatment for whooping cough will be determined by your doctor, based on:

• Your overall health and medical history

• Extent of the condition

• Your tolerance for specific medications, procedures, or therapies

• Expectations for the course of the condition

• Your opinion or preference

Antibiotics are typically given within 3 weeks of the onset of cough in babies over age 1 year, and within 6 weeks of the onset of cough in infants younger than 1 year. Antibiotics are also given to pregnant women within 6 weeks of the onset of cough. Antibiotics help to prevent the spread of infection after 5 days of treatment. Other treatment may include:

• Keeping warm

• Eating small, frequent meals

• Drinking plenty of fluids

• Reducing stimuli that may provoke coughing

Hospitalization may be required in severe cases.

Can whooping cough be prevented?

Although a vaccine has been developed against whooping cough, which is routinely given to children in their first year of life, cases of the disease still occur, especially in infants younger than age 6 months.

Since the 1980s, a dramatic increase in the number of cases of pertussis has occurred, especially in children and teenagers, ages 10 to 19, and in babies younger than age 6 months. This is because the decline in vaccination in some communities. The CDC recommends that children get 5 DTaP shots for maximum protection against pertussis. A DTaP shot is a combination vaccine that protects against 3 diseases: diphtheria, tetanus, and pertussis. The first 3 shots are given at ages 2, 4, and 6 months. The fourth shot is given between ages 15 and 18 months; the fifth shot is given when a child enters school at ages 4 to 6 years. At their regular checkups, preteens ages 11 or 12  years should get a dose of Tdap. The Tdap booster contains tetanus, diphtheria, and pertussis. If an adult did not get a Tdap as a preteen or teen, he or she should get a dose of Tdap instead of the Td booster. All adults should get a Td booster every 10 years, but it can be given before the 10-year mark. Pregnant women should have the booster late in the second trimester, or in the third trimester of each pregnancy. Always consult your health care provider for advice.