Whooping Cough

About Whooping Cough

Pertussis, or whooping cough, is a highly contagious respiratory disease caused by Bordetella pertussis. The disease has three stages. The catarrhal stage lasts 1 to 2 weeks and resembles a common cold with runny nose, mild cough, and low grade fever, during which the patient is most contagious. The paroxysmal stage lasts 2 to 6 weeks and is characterized by fits of rapid coughing paroxysms followed by a high pitched whoop as the patient gasps for air. Posttussive vomiting is common. The convalescent stage lasts 2 to 3 weeks with gradual resolution. Pertussis can affect all ages but is most severe in infants. A large proportion of infants under 1 year with pertussis need hospital care. Complications include pneumonia, seizures, encephalopathy, and death, mostly in young infants. Infants who have pauses in breathing, turn blue, or struggle to breathe need emergency care; call your local emergency number. Diagnosis is made through nasopharyngeal PCR or culture. Antibiotics such as azithromycin or clarithromycin are most effective in the catarrhal stage. Preventive antibiotics are offered to some close contacts, according to public health guidance. Prevention through DTaP vaccination for children and Tdap booster for adolescents and adults is critical. Neither vaccination nor infection provides lifelong immunity, and protection wanes over several years. Many countries recommend pertussis vaccination during each pregnancy, with timing set by national schedules, so that antibodies pass to the baby and protect the newborn until infant vaccination begins.