Family Medicine North  
     
     
Whooping Cough
 
 

Whooping cough is a serious, contagious, bacterial infection of the bronchial tubes and lungs. Immunization throughout the world has greatly decreased the incidence of whooping cough. It affects all ages, but is most common in children.

Frequent signs and symptoms

  • Early stages:
  • Runny nose
  • Dry cough that progresses to a cough with thick sputum
  • Slight fever
  • Late stages:
  • Severe, continual coughing bouts that last up to 1 minute. The fact turns red or blue from lack of oxygen while coughing. At the end of each coughing effort, the child gasps for breath with a “whooping” sound
  • Vomiting and diarrhea
  • Fever

Causes
Infection with Bordetella pertussis bacteria.
The disease is transmitted by direct contact with a contagious person, or by indirect contact, such as breathing air containing infected droplets or handling linen or other contaminated articles. The incubation period is 5 to 7 days.

Risk factors
Risk increases with:

  • Non-immunized populations
  • Epidemics in late winter or early spring. The bacteria become more virulent as they spread
  • Crowded or unsanitary living conditions
  • Pregnancy

Preventive measures

  • Obtain immunizations against whooping cough for all children. Immunizations normally begin at 2 months. Immunizations after age 5 is not recommended. \
  • Isolate infected persons.

Expected outcome

  • Usually curable in about 6 weeks with treatment (may range from 3 weeks to 3 months). The usual course of illness is: 2 weeks with the non-characteristic cough; 2 weeks with bouts of the “whooping” cough; and 2 weeks for convalescence. Some persistent coughs may continue for months.
  • Possible complications
  • Children under 1 year of age are subject to severe complications or death
  • Nosebleeds
  • Retinal detachment
  • Seizures and encephalitis
  • Pneumonia
  • Apnea (slowed or stopped breathing)
  • Middle-ear infection
  • Ruptured blood vessels in the brain

Diagnosis and treatment

  • Diagnostic tests may include laboratory blood studies, culture of sputum and chest X-ray.
  • Hospitalization with intensive care for severely ill infants. Older children can usually be treated at home.
  • Isolate the ill person until fever disappears. Necessary visitors should wear masks.
  • During a coughing bout in a baby, raise the foot of the crib. Place the baby face down with the head turned to one side to help drain the lungs. Older children usually prefer to sit up and lean forward during coughing bouts.
  • Use a cool-mist, ultrasonic humidifier to soothe the cough and help loosen bronchial and lung secretions. Clean humidifier daily.
  • Don’t use cough medication unless prescribed
  • Erythromycin started during the incubation period may be recommended.
  • Antibiotics may be prescribed for complications, such as middle-ear infection or pneumonia.
  • Keep the child in bed until the fever disappears. Normal activity should be resumed slowly, according to strength.
  • Encourage extra fluids, such as fruit juice, tea, carbonated drinks and bouillon.
  • No special diet is needed. Small, frequent meals may decrease vomiting.

Notify our office if

  • Your child has signs of whooping cough, especially blueness of the face with coughing bouts
  • Fever occurs
  • Vomiting persists more than 1 or 2 days

For more information: