Daniel Hagerman, MD Pediatrics

May 25, 2012

Pertussis or whooping cough may sound like a disease of a bygone time.

Despite vaccination as part of the DTaP series, pertussis is on the rise again. Infants who have not received the entire round of vaccinations and teenagers or adults whose immunity has faded are the most susceptible to contracting this highly contagious bacterial infection. Babies six months and younger are at the greatest risk. Even fully vaccinated children can get infected since the pertussis vaccine is only about 85 – 90 percent protective.

Pertussis is spread through coughing. When pertussis bacteria enter the respiratory tract, they produce toxins that make it difficult for the body to fight the bacteria and thick mucus that induces coughing. All that coughing causes airway inflammation as well, making it difficult to breathe.

Symptoms may begin to appear three to 12 days after infection. Pertussis may be mistaken as a common cold, as early symptoms include runny nose or congestion, sneezing, watery eyes, a mild fever and a dry cough. As symptoms worsen, severe coughing attacks may occur that produce phlegm, vomiting, shortness of breath and exhaustion. In some cases, a high-pitched “whooping” sound will occur after prolonged coughing during the next breath. Infants typically do not produce this sound, so you should not wait for it to be an indicator before taking your baby to the doctor.

So, when should you visit your doctor?

If the cough has caused your baby to vomit, turn red or blue in the face or make a “whooping” sound, you should visit the doctor. Babies under six months are most likely to require hospital treatment for pertussis. Babies with pertussis may develop pneumonia, seizures, and even brain damage due to low oxygen intake.

What tests are used to diagnose pertussis?

Because it may resemble the common cold, pertussis may be difficult to diagnose in its early stages. Your doctor may suspect pertussis just by listening to the cough. A nasal swab can be done to test for the whooping cough bacteria. A chest x-ray can also be done to view inflammation or fluid in the lungs and rule out pneumonia.

What are the treatments for pertussis?

Because whooping cough is most dangerous for infants, infants may need to be hospitalized once diagnosed. IV fluids may be needed to maintain hydration. Older children can typically be managed at home with prescription antibiotics. Unless prescribed by your doctor, over-the-counter cough suppressants should not be used. Coughing is how the lungs naturally clear themselves of mucus, so cough suppressants may make things worse.

Antibiotics generally do not shorten the length of the illness, but they lessen the chance of spreading the bacteria to others. Family members may be given preventive antibiotics or a booster shot of the Tdap vaccine to stop the spread of the infection. It is possible to get whooping cough more than once.

The best way to protect your baby against pertussis is to get the full round of the DTaP vaccination. It is vital that your baby finishes the entire series of immunizations to help fully protect him or her.