Whooping cough
What are the symptoms of Pertussis?
Pertussis can cause serious illness in infants, children and adults. The disease starts like the common cold, with runny nose or congestion, sneezing, and maybe mild cough or fever. But after 1–2 weeks, severe coughing begins. Infants and children with the disease cough violently and rapidly, over and over, until the air is gone from their lungs and they're forced to inhale with a loud 'whooping' sound. Pertussis is most severe for babies; more than half of infants less than 1 year of age who get the disease must be hospitalized. About 1 in 20 infants with pertussis get pneumonia (lung infection), and about 1 in 100 will have convulsions. In rare cases, pertussis can be deadly, especially in infants.
What causes Pertussis?
People with pertussis usually spread the disease by coughing or sneezing while in close contact with others, who then breathe in the pertussis bacteria. Many infants who get pertussis are infected by parents, older siblings, or other caregivers who might not even know they have the disease.
Who is at highest risk?
As noted above, Pertussis much more serious for babies and infants, often requiring hospitalization.
When to seek urgent medical care?
When you or your child develops a cold that includes a prolonged or severe cough, it may be pertussis. The best way to know is to contact your doctor.
Diagnosis
Methods used in laboratory diagnosis include culturing of nasopharyngeal swabs on Bordet-Gengou medium, polymerase chain reaction (PCR), direct immunofluorescence (DFA), and serological methods. The bacteria can be recovered from the patient only during the first three weeks of illness, rendering culturing and DFA useless after this period, although PCR may have some limited usefulness for an additional three weeks. For most adults and adolescents, who often do not seek medical care until several weeks into their illness, serology is often used to determine whether antibody against pertussis toxin or another component of B. pertussis is present at high levels in the blood of the patient. By this stage they have been contagious for some weeks. Because of this, adults, who are not in great danger from pertussis, are increasingly being encouraged to be vaccinated.
Treatment options
If started early enough, antibiotics such as erythromycin can make the symptoms go away more quickly. Unfortunately, most patients are diagnosed too late, when antibiotics aren't very effective. However, the medicines can help reduce the patient's ability to spread the disease to others. Infants younger than 18 months need constant supervision because their breathing may temporarily stop during coughing spells. Infants with severe cases should be hospitalized.
Other treatment options include:
- An oxygen tent with high humidity may be used.
- Fluids may be given through a vein if coughing spells are severe enough to prevent the person from drinking enough fluids.
- Sedatives (medicines to make you sleepy) may be prescribed for young children.
- Cough mixtures, expectorants, and suppressants are usually not helpful and should NOT be used.
