Topic Overview
What is whooping cough?
Whooping cough is a
disease that causes very severe coughing that may last for months. You can
cough so hard that you hurt a rib.
Whooping cough is also called
pertussis.
Whooping cough is contagious. This means it spreads
easily from one person to another. You can prevent whooping cough by getting
shots, called vaccines, that protect you from the disease.
Whooping cough can lead to other problems, such as
pneumonia. These problems can be very serious in
adults ages 60 and older and in young children, especially babies who are born
early or have not had shots to prevent whooping cough.
With good
care, most people recover from whooping cough with no problems.
A person of any age can get whooping cough. You can get whooping cough more than one time, and you may get it years
apart. But you will be less likely to get it again if you get the shots as
recommended.
What causes whooping cough?
Whooping cough is
caused by bacteria that infect the top of the throat (pharynx) where it meets
the nasal passages. The bacteria bother the throat, which causes
coughing.
See a picture of the
respiratory system, including the pharynx.
Whooping cough spreads easily from person to person. When someone with
the disease coughs, sneezes, or laughs, tiny drops of fluid holding the
bacteria are put into the air. The bacteria can infect others when they breathe
in the drops or get them on their hands and touch their mouth or nose. After
the bacteria infect someone, symptoms appear about 7 to 14 days later.
What are the symptoms?
Adults usually have milder
symptoms than children. How bad your symptoms are also depends on whether you
had the vaccine and how long ago it was.
Symptoms of whooping
cough usually last 6 to 10 weeks, but they may last longer. In young children,
three stages can occur. Older children and adults don't always have the same
stages.
In stage 1, symptoms are like those
of a cold:
- You sneeze and have a runny nose, a mild
cough, watery eyes, and sometimes a mild fever.
- The symptoms last
from several days to 2 weeks.
- This is when you are most likely to
spread the disease.
In stage 2, the cold symptoms get
better, but the cough gets worse.
- The cough goes from a mild, dry, hacking
cough to a severe cough that you can't control.
- You may cough so
long and hard that you can't breathe. When you can take a breath of air, it may
make a whooping noise.
- After a coughing fit, you may vomit and
feel very tired.
- Between coughing fits, you feel normal.
- Symptoms are most severe in this stage. They usually last 2 to 4
weeks or longer.
In stage 3, you still have symptoms but you feel better and grow
stronger.
- The cough may get louder.
- Coughing fits may happen off and on for weeks.
- Coughing fits may flare up if you get a cold or have a similar
illness.
- This stage may last longer if you have never had the
vaccine.
How is whooping cough diagnosed?
Your doctor will
ask you about your symptoms and do a physical exam. He or she may
order tests to rule out other health problems. Your doctor may ask if you have
had the necessary shots.
It can sometimes be hard to diagnose
whooping cough, because a person appears healthy between coughing episodes.
Your doctor may take a sample of mucus from your nose or throat and have it tested for
the bacteria that cause whooping cough.
How is it treated?
You may be given
antibiotics. These make it less likely that you will
spread the disease. If you start taking the antibiotics when you first get
whooping cough, the disease may not last as long.
Young infants
usually are treated for whooping cough in the hospital so the doctor can see
how well the baby deals with and recovers from the coughing.
Over-the-counter medicines, such as cough syrups, have
not been shown to help whooping cough. You can increase your comfort by using a
humidifier and getting enough fluids.
Can whooping cough be prevented?
Immunizations can prevent whooping cough or reduce how bad it is. Children, starting at age 2 months, need a series of shots to protect against whooping cough. Children ages 11 and older and adults up to age 65 need one booster shot. This booster shot is also recommended for adults of any age who have or expect to have close contact with babies younger than 1 year old. Caregivers who never got the shots—and may not even know that they have the illness—can spread whooping cough to babies and to other people who aren't protected.
Washing your hands
often and staying away from people who have a bad cough may help you avoid
getting the disease.
If you get whooping cough, you can avoid
spreading it by taking antibiotics and waiting the right amount of time before
you and your children go back to school or work:
- Children with whooping cough need to take
antibiotics for at least 5 days before going back to day care or school. If
your child did not take antibiotics, wait 21 days after the start of symptoms
before sending your child to school or day care.1
- Adults or teens
who have whooping cough need to take antibiotics for at least 5 days before being
near young children or going to work at a school, a day care center, or a
health facility.1
Frequently Asked Questions
Learning about whooping cough: | |
Being diagnosed: | |
Getting treatment: | |
Ongoing concerns: | |
Symptoms
Symptoms of
whooping cough typically last 6 to 10 weeks (but may
last longer). In young children, three stages can occur. Older children and
adults don't always go through the same stages.
First stage
Symptoms like those of a cold begin and last for
several days to 2 weeks. Symptoms usually include sneezing, a runny nose, mild
coughing, watery eyes, and sometimes a mild fever. An infected person is most
contagious during this stage.
Second stage
The most serious symptoms occur
during this phase and last about 2 to 4 weeks or longer. As cold symptoms
fade, the cough gets worse. A dry, hacking cough turns into bursts of
uncontrollable, often violent coughing that may make it temporarily impossible
to breathe. This may happen up to 30 times a day. The person may quickly inhale
when trying to take a breath through airways narrowed by inflammation, which
sometimes creates a whooping noise.
In babies, coughing
spells:
- May be triggered by very slight stimulation, such as taking in
food or milk, sucking, exposure to a sudden sound or light, or stretching.
- May cause symptoms of flushed cheeks, pale or bluish complexion
from lack of oxygen, and bulging or watery eyes. A baby may also stick out his
or her tongue, push the chest forward, or flail arms and legs in distress.
- May be frightening to watch, although most babies recover and
regain control of their breathing on their own. Babies generally feel well
between coughing spells but may become exhausted from the physical effort of
coughing. It's also possible that your baby's breathing could stop for a short
time during the coughing spells. This is called apnea.
- May lead to hospitalization, especially if the baby is younger
than 4 months of age.
Third stage
The final stage, lasting for a few
weeks or months, is a gradual recovery period. Although the person gains
strength and begins to feel better, the cough may become louder and sound
worse. Coughing spells become less frequent but may flare up again if a cold or
other upper respiratory illness develops. This final stage may last longer in
people who were not given the whooping cough (pertussis) vaccine.
Complications, such as
pneumonia or exertion-related injuries from coughing,
such as a
hernia, can develop from whooping cough. These types
of health problems pose the most serious risk to children younger than 4 months
and to adults ages 60 and older.
Exams and Tests
A doctor considers the following when
making a preliminary diagnosis of
whooping cough (pertussis):
- Symptoms. A doctor may suspect whooping cough when a person
has recently had cold symptoms and a dry, hacking cough that progresses to
bursts of uncontrollable, often violent coughing that may make it temporarily
impossible to breathe. Fever, sore
throat, and wheezing are usually absent or very mild with whooping cough. When
present, these symptoms can help a doctor distinguish between whooping cough
and other conditions with similar symptoms, such as a cold or
bronchitis.
- Immunization status. An important consideration when making a preliminary diagnosis of
whooping cough (pertussis) is whether a person's immunizations against
pertussis are up to date.
- Community outbreaks. Whooping cough may be suspected when other cases of whooping
cough have recently been reported within the local community.
To diagnose whooping cough, doctors may test
mucus from the nasopharynx region, which is where
nasal passages meet the back of the throat. To collect a mucus sample, doctors
may pass a swab or suction tube deep into the back of the nose. The sample can
be tested by
culture. It is the most accurate method, but it takes
10 to 14 days to get the results. Polymerase chain reaction (PCR) is often used
along with culture to get test results within several days. PCR detects the
genetic material (DNA) of whooping cough bacteria.
The doctor may do more than one test to find out if you or your child has whooping cough. Treatment will usually start right away if your doctor strongly suspects
whooping cough as a cause of the symptoms.
Other tests may be done to rule out other
problems, to monitor the person's condition, or to find out whether
complications have developed.
- A
complete blood count or other blood tests may be done
to help rule out other diseases.
- Chest
X-rays may be done, especially in infants. Although
X-ray images often appear normal in whooping cough, they may be needed to rule
out other possible causes of symptoms or to find out whether
complications, such as
pneumonia, have developed.
- A
pulse oximeter may be used to check the blood oxygen
levels, which helps a doctor monitor how well the lungs are working and decide
what treatments to use.
Treatment Overview
The aim of treatment is to make
symptoms less severe and reduce the spread of infection to close
contacts.
Whooping cough
is generally treated with
antibiotics, which may help shorten the course of the
disease if they are taken early in the first stage of illness. But they may not
be prescribed right away, because it's hard to tell the difference between the
first symptoms of whooping cough and the symptoms of a common cold. As symptoms
progress, they become more distinctive of whooping cough. Antibiotics are
usually given at this point. Antibiotics can help reduce the spread of
infection while you are waiting for test results to confirm the diagnosis. Family members and others who have had
close contact with someone infected with whooping cough are usually prescribed
antibiotics before any symptoms start.1
Severe coughing spells can
significantly decrease the blood's oxygen supply. If a
pulse oximeter measurement finds that blood oxygen
levels are low, oxygen may be given for a short time through a
nasal cannula or an oxygen mask.
Infants,
especially those younger than 4 months, are typically hospitalized.
Hospitalization allows health professionals to make sure the baby is getting
enough fluids and nutrients. Also, the baby is monitored and evaluated for how
well he or she tolerates and recovers from coughing episodes. If needed, a baby
also may receive oxygen therapy and have mucus suctioned from his or her nose
and throat. Because suctioning mucus may trigger coughing spells, it is only
done in certain situations.
Emergency treatment
Call 911 or other emergency services immediately if a person stops breathing, turns blue, or becomes
unconscious. Start rescue breathing immediately or follow instructions given by
emergency services while you wait for help. For more information, see the
topic Dealing With Emergencies.
Home Treatment
If your child has
whooping cough (pertussis), the coughing spells can be
scary. To help manage the symptoms, you can:
- Create a quiet, calm, restful environment. Keep stimulation to
a minimum to help reduce the number of coughing spells.
- Control possible triggers of a coughing episode, such as smoke,
dust, sudden noises or lights, or changes in temperature.
- Give your child frequent, small sips of fluids and nutritious
foods to provide needed energy that coughing uses up.
- Use a
humidifier in your child's room. But watch closely to
see its effect. Sometimes humidity makes coughing spells worse, in which case
it should be avoided. Dry, hot, or polluted air may make coughing spells worse.
- Hold your child in a calming manner.
- Have your child who is age 1 year or older lie on his or her side or stomach rather than the
back. Lying on the back could trigger a coughing spell. If your baby is younger than 1 year old, talk to your baby's doctor about the best way to position your child.
Over-the-counter medicines, such as
cough suppressants and
antihistamines, have not been shown to help relieve
symptoms.
If your child has whooping cough, he or she can go back to school or day care after 5 days of taking antibiotics. But if your child does not take antibiotics, have him or her wait 21 days after the start of symptoms before going back to school or day care.1
Prevention
Frequent
hand-washing is important to help prevent the spread
of infection. Keep children away from people who have a bad cough, especially
if it may be related to whooping cough. If you have whooping cough, take antibiotics for at least 5 days before being near young children. And don't return to work in schools, day care centers, or health
facilities until after 5 days of antibiotics.
Immunizations are critical to preventing diseases such
as pertussis from becoming widespread (epidemic) problems. Children start
getting their
immunizations against pertussis(What is a PDF document?) at age 2 months. A total of 5 shots (injections)
are given at different times until ages 4 to 6 years. The vaccines for
diphtheria, tetanus, and pertussis are all in one shot called DTaP.
A
tetanus, diphtheria, and pertussis (Tdap) booster shot(What is a PDF document?) is needed for continued
protection. Tdap is recommended at age 11 or 12. Teens and adults
ages 13 to 64 who never got the Tdap shot should get it in place of a Td
(tetanus and diphtheria) shot. And all teens and adults (including adults older than 64) who have or expect to have close contact with a baby less than 1 year old should get this shot. Adults age 65 and older can get one dose if they choose to do so. For more information, see the topic
Immunizations.
Other Places To Get Help
Organizations
| American Academy of Family
Physicians |
| P.O. Box 11210 |
| Shawnee Mission, KS 66207-1210 |
| Web Address: | www.familydoctor.org |
| |
The American Academy of Family Physicians offers information on adult and child health conditions and healthy living. Its Web site has topics on medicines, doctor visits, physical and mental health issues, parenting, and more. |
|
| Centers for Disease Control and Prevention (CDC):
Vaccines and Immunizations |
| 1600 Clifton Road |
| Atlanta, GA 30333 |
| Phone: | 1-800-CDC-INFO (1-800-232-4636) |
| TDD: | 1-888-232-6348 |
| Email: | cdcinfo@cdc.gov |
| Web Address: | www.cdc.gov/vaccines |
| |
This CDC Web site has information about vaccines and the diseases that can
be prevented by immunization. The Web site includes the recommended
immunization schedules for children, teens, and adults. There is also
information about vaccine side effects and safety, school and state
requirements, and immunization records. Interactive schedules are also
available. |
|
| Centers for Disease Control and Prevention
(CDC) |
| 1600 Clifton Road |
| Atlanta, GA 30333 |
| Phone: | 1-800-CDC-INFO (1-800-232-4636) |
| TDD: | 1-888-232-6348 |
| Email: | cdcinfo@cdc.gov |
| Web Address: | www.cdc.gov |
| |
The Centers for Disease Control and Prevention (CDC) is
an agency of the U.S. Department of Health and Human Services. The CDC works
with state and local health officials and the public to achieve better health
for all people. The CDC creates the expertise, information, and tools that
people and communities need to protect their health—by promoting health,
preventing disease, injury, and disability, and being prepared for new health
threats. |
|
| KidsHealth for Parents, Children, and
Teens |
| 10140 Centurion Parkway North |
| Jacksonville, FL 32256 |
| Phone: | (904) 697-4100 |
| Fax: | (904) 697-4220 |
| Web Address: | www.kidshealth.org |
| |
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health, from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest. |
|
| National Network for Immunization
Information |
| 301 University Boulevard |
| Galveston, TX 77555 |
| Phone: | (703) 299-0789 |
| Fax: | (409) 772-5208 |
| Email: | nnii@i4ph.org |
| Web Address: | www.immunizationinfo.org |
| |
The National Network for Immunization Information provides
information on immunizations, including each of the recommended childhood
vaccines, the recommended childhood immunization schedule, tips on using the
World Wide Web as a source of immunization and health information, and links to
other helpful sites. You can also search for the vaccines that each state
requires before entry into school or day care. |
|
| Vaccines.gov |
| 200 Independence Avenue, Southwest |
| Washington, DC 20201 |
| Phone: | (800) CDC-INFO (800) 232-4636 |
| TDD: | 1-888-232-6348 |
| Email: | cdcinfo@cdc.gov |
| Web Address: | www.vaccines.gov |
| |
This U.S. Department of Health and Human Services website has vaccine information from many federal agencies. |
|
References
Citations
- American Academy of Pediatrics (2009). Pertussis
(whooping cough). In LK Pickering et al., eds., Red Book: 2009 Report of the Committee on Infectious Diseases, 28th ed., pp. 504–519. Elk
Grove Village, IL: American Academy of Pediatrics.
Other Works Consulted
- Bettiol S, et al. (2010). Symptomatic treatment of the cough in whooping cough. Cochrane Database of Systematic Reviews (1).
- Bravender T, Walter EB (2008). Pertussis section of Infectious respiratory illnesses. In LS Neinstein et al., eds., Adolescent Health Care: A Practical Guide, 5th ed., pp. 419–421. Philadelphia: Lippincott Williams and Wilkins.
- Centers for Disease Control and Prevention (2006).
Preventing tetanus, diphtheria, and pertussis among adolescents: Use of tetanus
toxoid, reduced diphtheria toxoid and acellular pertussis vaccines:
Recommendations of the Advisory Committee on Immunization Practices (ACIP).
MMWR, 55(RR-3): 1–44. Also available online:
http://www.cdc.gov/mmwr/PDF/RR/RR5503.pdf.
- Centers for Disease Control and Prevention (2011). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine from the Advisory Committee on Immunization Practices, 2010. MMWR, 60(01): 13–15. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6001a4.htm?s_cid=mm6001a4_w.
- Centers for Disease Control and Prevention (2011). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) in pregnant women and persons who have or anticipate having close contact with an infant aged <12 months: Advisory Committee on Immunization Practices (ACIP). MMWR, 60(41): 1424–1426. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6041a4.htm?s_cid=mm6041a4_e&source=govdelivery.
- Cherry JD, Harrison RE (2006). Bordetella pertussis (whooping cough). In FD Burg et al.,
eds., Current Pediatric Therapy, 18th ed., pp. 723–727.
Philadelphia: Saunders Elsevier.
- Connelly BL (2011). Pertussis. In CD Rudolph et al., eds., Rudolph’s Pediatrics, 22nd ed., pp. 1075–1077. New York: McGraw-Hill.
- Long SS (2011). Pertussis (bordetella pertussis and bordetella parapertussis). In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 944–948. Philadelphia: Saunders.
- Skerrett SJ (2009). Infections due to haemophilus, moraxella, legionella, bordetella, and pseudomonas. In EG Nabel, ed., ACP Medicine, section 7, chap. 10. Hamilton, ON: BC Decker.
- Zhang L, et al. (2011). Acellular vaccines for preventing whooping cough in children. Cochrane
Database of Systematic Reviews (1).
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | John Pope, MD - Pediatrics |
|---|
| Specialist Medical Reviewer | Christine Hahn, MD - Epidemiology |
|---|
| Last Revised | October 18, 2011 |
|---|
Seton is proud to have four hospitals – the only hospitals in Central Texas - that have earned the Magnet designation, the highest award for nursing excellence given by the American Nurses Association.