Pertussis, also known as whooping cough, is a highly contagious respiratory disease. It is caused by the bacterium Bordetella pertussis. Pertussis is known for uncontrollable, violent coughing which often makes it hard to breathe. After cough fits, someone with pertussis often needs to take deep breaths, which result in a “whooping” sound. Pertussis can affect people of all ages but can be very serious, even deadly, for babies less than a year old.

Causes 

Pertussis is a very contagious disease only found in humans. Pertussis spreads from person to person. People with pertussis usually spread the disease to another person by coughing or sneezing or when spending a lot of time near one another where you share breathing space. Many babies who get pertussis are infected by older siblings, parents, or caregivers who might not even know they have the disease.

Infected people are most contagious up to about 2 weeks after the cough begins. Antibiotics may shorten the amount of time someone is contagious.

While pertussis vaccines are the most effective tool to prevent this disease, no vaccine is 100% effective. When pertussis circulates in the community, there is a chance that a fully vaccinated person, of any age, can catch this disease. If you have gotten the pertussis vaccine but still get sick, the infection is usually not as bad.

Symptoms

Pertussis (whooping cough) can cause serious illness in babies, children, teens, and adults. Symptoms of pertussis usually develop within 5 to 10 days after you are exposed. Sometimes pertussis symptoms do not develop for as long as 3 weeks.

Early Symptoms: The disease usually starts with cold-like symptoms and maybe a mild cough or fever. In babies, the cough can be minimal or not even there. Babies may have a symptom known as “apnea.” Apnea is a pause in the child’s breathing pattern. Pertussis is most dangerous for babies. About half of babies younger than 1 year who get the disease need care in the hospital. 

In those who have gotten the pertussis vaccine:

• In most cases, the cough won’t last as many days
• Coughing fits, whooping, and vomiting after coughing fits occur less often
• The percentage of children with apnea (long pause in breathing), cyanosis (blue/purplish skin coloration due to lack of oxygen), and vomiting is less

Early symptoms can last for 1 to 2 weeks and usually include:

• Runny nose
• Low-grade fever (generally minimal throughout the course of the disease)
• A mild, occasional cough
• Apnea – a pause in breathing (in babies)

Pertussis in its early stages appears to be nothing more than the common cold. Therefore, healthcare professionals often do not suspect or diagnose it until the more severe symptoms appear.

Later-stage Symptoms: After 1 to 2 weeks and as the disease progresses, the traditional symptoms of pertussis may appear and include:

• Paroxysms (fits) of many, rapid coughs followed by a high-pitched “whoop” sound
• Vomiting (throwing up) during or after coughing fits
• Exhaustion (very tired) after coughing fits

Pertussis in Babies: It is important to know that many babies with pertussis don’t cough at all. Instead, it causes them to stop breathing and turn blue.

Pertussis can cause violent and rapid coughing, over and over, until the air is gone from your lungs. When there is no more air in the lungs, you are forced to inhale with a loud “whooping” sound. This extreme coughing can cause you to throw up and be very tired. Although you are often exhausted after a coughing fit, you usually appear fairly well in-between. Coughing fits generally become more common and bad as the illness continues, and can occur more often at night. The coughing fits can go on for up to 10 weeks or more.

The “whoop” is often not there if you have the milder (less serious) disease. The infection is generally milder in teens and adults, especially those who have gotten the pertussis vaccine (www.cdc.gov).

Prevention

The best way to prevent pertussis (whooping cough) among babies, children, teens, pregnant women, and adults is to get vaccinated. Also, keep babies and other people at high risk for pertussis complications away from infected people.

Two vaccines in the United States help prevent whooping cough: DTaP and Tdap. These vaccines also provide protection against tetanus and diphtheria. 

Treatment

Treatment depends on the duration of the illness and the severity of its symptoms. Whooping cough treatment usually involves antibiotic therapy. Early antibiotic treatment may reduce symptom severity, speed up recovery time, and prevent people from transmitting the bacteria. A healthcare professional might prescribe antibiotics for other members of the household as well.

According to the Centers for Disease Control and Prevention (CDC), antibacterial treatments are most effective during the first 2–3 weeks of infection or before coughing fits begin. However, people rarely receive treatment early enough to experience these benefits.

Home remedies for whooping cough include:

• staying hydrated
• resting
• using a mist vaporizer
• practicing proper hand hygiene
• eating frequent small meals rather than three large meals to avoid vomiting
• avoiding coughing triggers, such as smoke, strong chemicals, and allergens

Whooping cough does not respond to traditional cough medication. The American Lung Association advises against treating whooping cough with cough medications.

Recovering from whooping cough can take several weeks, and a cough can continue to linger for many months.

Supportive Links:

“Cochrane Review: Antibiotics for whooping cough (pertussis).” Evidence‐Based Child Health: A Cochrane Review Journal 7.3 (2012): 893-956.

https://onlinelibrary.wiley.com/doi/abs/10.1002/ebch.1845

“Pertussis-induced cough.” Pulmonary Pharmacology & Therapeutics 24.3 (2011): 304-307.

https://www.sciencedirect.com/science/article/abs/pii/S1094553910001252

 “Symptomatic treatment of the cough in whooping cough.” Cochrane Database of Systematic Reviews 9 (2014).

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003257.pub5/abstract

Note: “Western Pharmaceutical” is defined as a system in which medical doctors and other healthcare professionals (such as nurses, pharmacists, and therapists) treat symptoms and diseases using drugs, radiation, or surgery. Quote from National Cancer Institute: http://www.cancer.gov