Pertussis is a highly contagious bacterial disease of the respiratory tract, caused by Bordetella pertussis. It occurs mainly in infants and young children, and is easily transmitted from person to person, mainly through droplets. The first symptoms generally appear 7–10 days after infection, and include mild fever, runny nose, and cough, which in typical cases gradually develops into a paroxysmal cough followed by whooping (hence the common name of whooping cough).In the youngest infants, the paroxysms may be followed by periods of apnoea. Pneumonia is a relatively common complication; seizures and encephalopathy occur more rarely. Untreated patients may be contagious for three weeks or more following onset of the cough. Pertussis can be prevented by immunization.
Before a vaccine was available, pertussis killed 5,000 to 10,000 people in the United States each year. Now, the pertussis vaccine has reduced the annual number of deaths to less than 30. But in recent years, the number of cases has started to rise. By 2004, the number of whooping cough cases spiked past 25,000, the highest level it’s been since the 1950s. Although many infants and younger children who become infected with B. pertussis will develop the characteristic coughing episodes and accompanying whoop, not all will. And sometimes infants don’t cough or whoop as older kids do. Infants may look as if they’re gasping for air with a reddened face and may actually stop breathing (called apnea) for a few seconds during particularly bad spells.
If started early enough, antibiotics such as erythromycin can make the symptoms go away more quickly. Unfortunately, most patients are diagnosed too late, when antibiotics aren’t very effective. However, the medicines can help reduce the patient’s ability to spread the disease to others.Infants younger than 18 months need constant supervision because their breathing may temporarily stop during coughing spells. Infants with severe cases should be hospitalized. An oxygen tent with high humidity may be used. Fluids may be given through a vein if coughing spells are severe enough to prevent the person from drinking enough fluids. Sedatives (medicines to make you sleepy) may be prescribed for young children. Cough mixtures, expectorants, and suppressants are usually not helpful and should NOT be used.
During recovery, let your child rest in bed and use a cool-mist vaporizer to help loosen respiratory secretions and soothe irritated lungs and breathing passages. (Be sure to follow directions for keeping it clean and mold-free.) In addition, keep your home free of irritants that can trigger coughing spells, such as aerosol sprays; tobacco smoke; and smoke from cooking, fireplaces, and wood-burning stoves.
One of the recommended childhood immunizations, a DTaP vaccination, protects children against pertussis infection. DTaP vaccine can be safely given to infants. They are usually given to children at ages 2 months, 4 months, 6 months, 15-18 months, and 4-6 years. The Tdap vaccine should be given around age 11 or 12, and every 10 years thereafter. During a pertussis outbreak, unimmunized children under age 7 should not attend school or public gatherings, and should be isolated from anyone known or suspected to be infected. This should last until 14 days after the last reported case. Many health care organizations strongly recommend that adults up to the age of 65 years receive the adult form of the vaccine against pertussis.