Pertussis, or whooping cough, is caused by bacteria that attack the lining of the breathing passages. This causes inflammation and narrowing of the airways. Severe coughing is one of the major symptoms.
Because a child is short of breath, they inhale deeply and quickly between coughs. The breaths often make a "whooping" sounds, which is how this illness got its common name. The intense coughing scatters the pertussis bacteria into the air, and can spread the disease to others.
Pertussis on the rise
Many years ago, there were several hundred thousand cases of whooping cough each year in the United States. With the development of a
vaccine for pertussis, that number dropped. But in recent years, U.S. cases have gone up. Because of this, giving the pertussis vaccine to children and their caregivers is more important than ever.
Infants under one year of age are at greatest risk of developing severe breathing problems and life-threatening illness from whooping cough.
Symptoms of pertussis
Pertussis often acts like a common cold for a week or two. Then the cough gets worse (rather than better, as usually happens with a cold), and older children may start to have the characteristic "whoop." During this phase, which can last two weeks or more, your child may often be short of breath. They may look bluish around the mouth. In addition, they may tear, drool, and vomit.
Young infants with pertussis may have episodes where they appear to stop breathing or have vomiting after a long bout of coughs. Infants with pertussis become exhausted and develop complications, becoming more vulnerable to other infections, pneumonia, and seizures. Pertussis can be fatal in some infants, but the usual course is for recovery to begin after two to four more weeks.
The cough of pertussis, which has also been called the "100 day cough," may not disappear for months, and may return with future respiratory infections.
When to call the pediatrician
Pertussis infection starts out acting like a cold. You should consider the possibility of whooping cough if:
Your child is a very young infant who has not been fully immunized and/or has had exposure to someone with a chronic cough or the disease.
Their cough becomes more severe and frequent, or their lips and fingertips become dark or blue.
They become exhausted after coughing episodes, eat poorly, vomit after coughing, and look "sick."
When your child needs hospital care
Most infants who are less than six months old with whooping cough need to be initially treated in the hospital. Slightly less than half of older babies with the disease are initially treated in the hospital, too. This more intensive care can decrease the chances of complications. These complications can include pneumonia, which occurs in slightly less than one fourth of children under one year old who have whooping cough. If your child is older, they are more likely to be treated only at home.
While in the hospital, your child may need to have the thick respiratory secretions suctioned. Their breathing will be monitored, and they may need to be given oxygen. Your child will be isolated from other patients to keep the infection from spreading to them.
Treatment for pertussis
Whooping cough is treated with an antibiotic that is most effective when given in the first stage of illness, before the coughing spells begin. Although antibiotics can stop the spread of the whooping cough infection, they cannot prevent or treat the cough itself. Because cough medicines do not relieve the coughing spells, your pediatrician probably will recommend other forms of home treatment to help manage the cough.
Let your child rest in bed and use a cool-mist vaporizer to help soothe their irritated lungs and breathing passages. A vaporizer also will help loosen secretions in the respiratory tract.
Ask your pediatrician for instructions on the best position for your child to help drain those secretions and improve breathing. Also ask whether antibiotics or vaccine boosters need to be given to others in your household to prevent them from developing the disease. Your child should stay home from child care until finishing five days of antibiotics.
How to protect your baby against pertussis
The best way to protect your child against pertussis is with DTaP vaccination (immunizations at two months, four months, and six months of age, and booster shots at twelve to eighteen months and at four or five years of age or prior to starting school). See Recommended Immunization Schedules.
Parents or family members who will be in close contact with babies younger than one year old should also receive the
Tdap booster. This lowers the risk of passing the infection to the infant.
In addition, all women who are pregnant should get the Tdap vaccine during each pregnancy. This allows mothers to pass on protection against pertussis to their newborns.