Pertussis (Whooping Cough)
Pertussis: What You Need to Know Nicole Baldwin, MD FAAP
What is Pertussis? Pertussis (aka Whooping Cough) is a bacterial infection that manifests initially as a mild upper respiratory tract infection that is often mistaken for a common cold. Unlike the common cold, however, pertussis progresses into paroxysms (or fits) of coughing, which are often followed by an inspiratory “whooping” sound and/or vomiting. Click here to hear what pertussis sounds like.
How long does Pertussis last? Pertussis typically lasts 6-10 weeks.
How is Pertussis spread? Pertussis is spread through airborne droplets. It is highly contagious to anyone in close contact (living in the same house, caregivers, close friends) with someone who has pertussis.
How is Pertussis treated? Any person diagnosed with pertussis should receive antibiotic therapy (generally a 5 day course of azithromycin) to prevent transmission to others. Unfortunately, once the illness has progressed past the upper respiratory phase and into the coughing phase, treatment with azithromycin or another antibiotic WILL NOT relieve the symptoms, but it will render the person no longer contagious and able to return to school or work (after the full course of antibiotic treatment is completed), despite the cough. If one chooses to forgo antibiotic therapy, they will not be able to return to work or school for 21 days after the cough began.
Who is at risk for Pertussis? Unfortunately we are all at risk for pertussis, but certain age groups are at higher risk. Newborns and infants under 6 months of age are at the highest risk for both infection and complication from infection. Children between the ages of 7-10 who have not received their Tdap booster (given at 11 years) are also at higher risk for pertussis due to the decreasing immunity from their primary series of vaccines in infancy. Adults who have not received a Tdap booster are also at increased risk of disease.
Can Pertussis be prevented? The best way to protect yourself and your child is through immunization. All infants should receive the DTaP vaccine at 2,4,and 6 months of age with a booster at 12-18 months and another at 4-6 years. Adolescents should receive a booster Tdap vaccine at age 11. Adults who have not received a Tdap booster should receive one as well. In 2011, the CDC and ACIP recommended that all pregnant women receive a Tdap vaccine during each pregnancy (regardless of prior immunization status) to minimize the risk of transmission to newborns from their mothers as well as provide some passive immunity to the infant from maternal antibodies passed through the placenta before birth.
When a person has been exposed to someone with a confirmed case of pertussis, preventative antibiotic therapy may be initiated (in certain circumstances) to attempt to prevent transmission of pertussis. Please call your healthcare provider to discuss the need for prophylactic antibiotics if you or your child has been exposed to pertussis.
Why should I care…it’s just a cough, right? Pertussis is more than “just a cough.” There are approximately 300,000 deaths worldwide due to pertussis. Approximately 50% of infants under the age of 1 that are diagnosed with pertussis need hospitalization. Of the infants who are hospitalized:
• 1 in 4 (23%) get pneumonia (lung infection)
• 1 or 2 in 100 (1.6%) will have convulsions (violent, uncontrolled shaking)
• Two thirds (67%) will have apnea (slowed or stopped breathing) • 1 in 300 (0.4%) will have encephalopathy (disease of the brain)
• 1 or 2 in 100 (1.6%) will die
Teens and adults can have complications as well including: weight loss, loss of bladder control, passing out, and rib fractures from severe coughing.
If you or your child has been exposed to pertussis, please call your health care provider right away so we can help stop the spread! If you believe that you or your child may have pertussis, it is imperative that you seek testing and treatment as soon as possible. Please feel free to call our office with any questions or concerns you may have.
References:
1. American Academy of Pediatrics. Red Book: 2012 Report of the Committee on Infectious Diseases. Pickering LK, ed. 29th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2012.
2. http://www.cdc.gov/pertussis/index.html