Whooping Cough (Pertussis): Symptoms, Treatment and Prevention

Whooping cough, or pertussis, is a respiratory infection that causes fits of coughing. In serious cases the coughing becomes violent and rapid, sometimes hard enough to cause vomiting. It is named for the "whoop" some people make as they gasp for breath after coughing. It is very contagious and can affect anyone, but it is especially dangerous for babies too young to be vaccinated: about half of infants under one who catch it need hospital care.

Cause and spread

It is caused by the bacterium Bordetella pertussis, which spreads between people mainly through coughing, sneezing or breathing very close to someone, and sometimes by touching a contaminated surface and then your nose or mouth. People are contagious for about 2 weeks after their cough starts; antibiotics may shorten that.

Symptoms

They usually begin 5 to 10 days after exposure, sometimes up to 3 weeks later.

• Early stage (1 to 2 weeks): like a cold, with a runny nose, mild fever and a mild, occasional cough. Babies may barely cough at all, but may have apnea, pauses in breathing, and turn blue: get medical care right away.
• Later: fits of many rapid coughs followed by a high-pitched "whoop", vomiting during or after the fits, and exhaustion. The fits grow worse and more frequent, especially at night, and can go on for up to 10 weeks or more.
• Recovery is slow, with a milder, less frequent cough. The fits can return with another respiratory infection, even months later.

Diagnosis

A provider may use a medical history, a physical exam, a lab test of mucus from the back of the throat taken through the nose with a swab or a saline-filled syringe, a blood test and a chest x-ray.

Treatment

Usually antibiotics, and early treatment matters: it can make the infection milder and help stop it spreading. After 3 weeks or more of illness, treatment may not help, because the bacteria are gone even though the damage they did still causes symptoms. Severe cases may need hospital care.

Prevention

• Vaccines are the best protection. Two are used in the United States, DTaP and Tdap, which also protect against tetanus and diphtheria (more on these vaccines).
• Keep babies and others at high risk away from anyone with whooping cough.
• Providers sometimes give antibiotics to family members or others exposed, to prevent illness.
• Everyday habits help too: wash hands often (or use alcohol-based hand rub), avoid touching your face with unwashed hands, clean and disinfect frequently touched surfaces and toys, cough or sneeze into a tissue or sleeve, stay home when sick, and avoid close contact with sick people.

Sources

• MedlinePlus, U.S. National Library of Medicine, "Whooping Cough," from the Centers for Disease Control and Prevention. https://medlineplus.gov/whoopingcough.html
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