by Michelle Quirk, MD
Pediatric Hospitalist
Children’s Hospital of Philadelphia Care Network at Chester County Hospital
Pertussis, or "whooping cough", is a bacterial infection that causes severe cough and can be deadly to young children. You may have seen reports of pertussis outbreaks in the news or in the local school systems, as the bacteria is extremely contagious and is very easily and quickly spread among those in close contact with an infected individual. The best way to protect yourself against pertussis is by getting vaccinated, but first, let's talk about the illness.
Whooping cough is caused by the bacteria, Bordetella pertussis. It spreads from person to person when someone who is infected coughs or sneezes. Many infants become infected by older siblings, parents, grandparents, or caregivers who might not even know they have the disease.
The symptoms of whooping cough in its early stages can look like a cold: runny nose, congestion, sneezing, and a mild cough. After 1-2 weeks, the cold symptoms may improve, but the cough tends to become much worse. The severe coughing fits can cause kids to choke, throw up mucus, and gag. Children can become short of breath, can have a bluish color on the lips or around the mouth due to a lack of oxygen, and can experience trouble breathing. Whooping cough got its name from the characteristic “whoop” sound you hear when those with the infection breathe in after a coughing fit.
If your child starts to show these symptoms, it is important to have them evaluated by a doctor right away, especially if their cough becomes more severe and more frequent, the child’s lips turn blue, the child is a young infant who has not been fully immunized or has been exposed to an infected individual, the child appears tired or exhausted with coughing episodes, or if they are having difficulty eating or drinking liquids.
Infants under one year old are at the greatest risk of developing severe respiratory problems from pertussis. The majority of deaths related to whooping cough actually occur in infants younger than 3 months old. While the illness can generally be prevented with vaccination, infants are a particularly vulnerable group, since they have not yet received all of their vaccinations for whooping cough.
If an infant becomes infected with pertussis, most unfortunately need to be treated in the hospital due to the severity of illness. The illness can cause babies to become tired and require respiratory support, develop other infections such as pneumonia, and have seizures. Infants are monitored closely for complications, and can be given respiratory support, oxygen, and suctioning of mucus from the airway to help with breathing. They can also be given fluids, electrolytes, and nutrition, if needed.
Pertussis is treated with a short round of antibiotics to fight the infection and other supportive measures to ease the symptoms. While antibiotics can help to stop the spread of the infection, they do not treat the cough. Others who had close contact with the patient may also need to take antibiotics, even if they do not yet have any symptoms.
The best way to protect your child against whooping cough is through vaccination. The American Academy of Pediatrics recommends that children receive a DTaP vaccination at two months, four months, and six months of age, with a booster given at fifteen to eighteen months, and again at four to six years. For children seven to ten years old who were underimmunized with DTaP, or who have an incomplete vaccine history, a Tdap vaccine can be given. Pregnant women should also receive the Tdap vaccine, as well as adults who have contact with infants, and health care workers. While the vaccine is the best tool to prevent the disease, there is a small chance that a fully vaccinated individual of any age can still catch whooping cough, though the illness is usually not as bad.
In addition to vaccination, you can also stop the spread of pertussis and other respiratory infections by washing your hands often, covering your mouth when you cough or wearing a mask, and avoiding being near infants and young children when you are ill.
For more information on whooping cough and how to prevent it, talk with your doctor, and check out the following websites:
Related Information from Chester County Hospital: