Pertussis

Whooping Cough (Pertussis) in Adults

What is whooping cough (pertussis)?

Whooping cough, or pertussis, is very contagious and primarily affects infants and young children. Caused by a bacterium called bordetella pertussis, it is characterized by paroxysms (intense spells) of coughing that end with a characteristic "whoop" as air is inhaled. Whooping cough caused thousands of deaths in the 1930s and 1940s, but, with the advent of a vaccine, the rate of death has declined dramatically. Even though pertussis vaccines are very effective, if pertussis is circulating in the community, there is a possibility that even a fully vaccinated person can catch the disease.

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 one to two weeks, severe coughing begins. The following are the most common symptoms of whooping cough. However, each individual may experience symptoms differently. Infants less then 6 months old may not have a classic whooping cough or it may be difficult to hear. Instead of coughing, infants may have something called apnea or a pause in breathing, which is very serious. You should consult your doctor or call your local emergency number if you observe pauses in breathing. Symptoms 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.

The symptoms of whooping cough may resemble other medical conditions. Always consult your doctor for a diagnosis.

How is whooping cough diagnosed?

In addition to a complete medical history and medical examination, 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 generally not helpful once severe coughing has begun, but do help to prevent the spread of infection after three or four 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 the first year of life, cases of the disease still occur, especially in infants younger than 6 months of age.

According to the CDC, there has been a dramatic increase in the number of cases of pertussis since the 1980s, especially in teenagers (10 to 19 years of age) and babies less than 6 months of age. The CDC recommends that children need five DTaP shots for maximum protection against pertussis. A DTaP shot is a combination vaccine that protects against three diseases: diphtheria, tetanus, and pertussis. The first three shots are given at 2, 4, and 6 months of age. Between 15 and 18 months of age, the fourth shot is given, and a fifth shot when a child enters school at 4 to 6 years of age. At regular checkups for 11- or 12-year-olds, a preteen 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 19-64 years old should get a Td booster every 10 years, but it can be given before the 10-year mark. Adults 65 and older should get a one-time booster if they are going to be around newborns and infants less then 12 months old. And pregnant women who are not already vaccinated should have the booster late in the second trimester or in the third trimester. Always consult your doctor for advice.

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