WHOOPING COUGH

General Information

DEFINITION--A serious, contagious, bacterial infection of the bronchial tubes and lungs. Immunization throughout the world has greatly decreased the incidence of whooping cough.

BODY PARTS INVOLVED--Bronchial tubes; larynx; lungs.

SEX OR AGE MOST AFFECTED--All ages, but most common in children.

SIGNS & SYMPTOMS

Early stages:

• Runny nose.
• Dry cough that progresses to a cough with thick sputum.
• Slight fever.

Later stages:

• Severe, continual coughing bouts that last up to 1 minute. The face 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 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.

HOW TO PREVENT

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

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• Laboratory studies, such as culture of the sputum and x-rays of the chest.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization with intensive care for severely ill infants. Older children can usually be treated at home.

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.

PROBABLE 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.

How To Treat

GENERAL MEASURES--

• 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.

MEDICATION--

• Don't use cough medicine unless prescribed.
• Your doctor may prescribe: Erythromycin started during the incubation period. Antibiotics for complications, such as middle-ear infection or pneumonia.

ACTIVITY--Keep the child in bed until the fever disappears. Normal activity should be resumed slowly, according to strength.

DIET--

• Encourage extra fluids, such as fruit juice, tea, carbonated drinks and bouillon.
• No special diet. Small, frequent meals may decrease vomiting.

Call Your Doctor If

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