Causes & Transmission Causes Pertussis:
A respiratory illness commonly known as whooping cough, is a very contagious disease caused by a type of bacteria called Bordetella pertussis. These bacteria attach to the cilia (tiny, hair-like extensions) that line part of the upper respiratory system. The bacteria release toxins, which damage the cilia and cause inflammation (swelling).transmission pertussis is a very contagious disease only found in humans and is spread from person to person. People with pertussis usually spread the disease by coughing or sneezing while in close contact with others, who then breathe in the pertussis bacteria. Many infants who get pertussis are infected by older siblings, parents or caregivers who might not even know they have the disease.
Signs & Symptoms:
Pertussis (whooping cough) can cause serious illness in infants, children and adults. The disease usually starts with cold-like symptoms and maybe a mild cough or fever. After 1 to 2 weeks, severe coughing can begin. Unlike the common cold, pertussis can become a series of coughing fits that continues for weeks.
In infants, the cough can be minimal or not even there. Infants may have a symptom known as "apnea." Apnea is a pause in the child’s breathing pattern. Pertussis is most dangerous for babies. More than half of infants younger than 1 year of age who get the disease must be hospitalized.
Pertussis can cause violent and rapid coughing, over and over, until the air is gone from the lungs and you are forced to inhale with a loud "whooping" sound. This extreme coughing can cause you to throw up and be very tired. The "whoop" is often not there and the infection is generally milder (less severe) in teens and adults, especially those who have been vaccinated.
Early symptoms can last for 1 to 2 weeks and usually include:
- Runny nose
- Low-grade fever (generally minimal throughout the course of the disease)
- Mild, occasional cough
- Apnea – a pause in breathing (in infants)
Because pertussis in its early stages appears to be nothing more than the common cold, it is often not suspected or diagnosed until the more severe symptoms appear. Infected people are most contagious during this time, up to about 2 weeks after the cough begins. Antibiotics may shorten the amount of time someone is contagious.
As the disease progresses, the traditional symptoms of pertussis appear and include:
- Paroxysms (fits) of many, rapid coughs followed by a high-pitched "whoop"
- Vomiting (throwing up)
- Exhaustion (very tired) after coughing fits
The coughing fits can go on for up to 10 weeks or more.
Although you are often exhausted after a coughing fit, you usually appear fairly well in-between. Coughing fits generally become more common and severe as the illness continues, and can occur more often at night. The illness can be milder (less severe) and the typical "whoop" absent in children, teens, and adults who have been vaccinated.
Recovery from pertussis can happen slowly. The cough becomes less severe and less common. However, coughing fits can return with other respiratory infections for many months after pertussis started.
Complications Infants and Children:
Pertussis (whooping cough) can cause serious and sometimes life-threatening complications in infants and young children, especially those who are not fully vaccinated.
In infants younger than 1 year of age who get pertussis, more than half must be hospitalized. The younger the infant, the more likely treatment in the hospital will be needed. Of those infants who are hospitalized with pertussis about:
- 1 in 5 get pneumonia (lung infection)
- 1 in 100 will have convulsions (violent, uncontrolled shaking)
- Half will have apnea (slowed or stopped breathing)
- 1 in 300 will have encephalopathy (disease of the brain)
- 1 in 100 will die
Teens and Adults:
Teens and adults can also get complications from pertussis. They are usually less serious in this older age group, especially in those who have been vaccinated. Complications in teens and adults are often caused by the cough itself. For example, you may pass out or fracture a rib during violent coughing fits.
In one study, less than 5% of teens and adults with pertussis were hospitalized. Pneumonia (lung infection) was diagnosed in 2% of those patients. The most common complications in another study of adults with pertussis were:
- Weight loss (33%)
- Loss of bladder control (28%)
- Passing out (6%)
- Rib fractures from severe coughing (4%)
Pertussis (whooping cough) can be diagnosed by taking into consideration if you have been exposed to pertussis and by doing a:
Pertussis is generally treated with antibiotics and early treatment is very important. Treatment may make your infection less severe if it is started early, before coughing fits begin. Treatment can also help prevent spreading the disease to close contacts (people who have spent a lot of time around the infected person) and is necessary for stopping the spread of pertussis. Treatment after three weeks of illness is unlikely to help because the bacteria are gone from your body, even though you usually will still have symptoms. This is because the bacteria have already done damage to your body.
There are several antibiotics available to treat pertussis. If you or your child is diagnosed with pertussis, your provider will explain how to treat the infection.
If Your Child is Treated for Pertussis at Home
Manage pertussis and reduce the risk of spreading it to others by:
- Following the schedule for giving antibiotics exactly as you are prescribed.
- Keeping your home free from irritants - as much as possible - that can trigger coughing, such as smoke, dust, and chemical fumes.
- Using a clean, cool mist vaporizer to help loosen secretions and soothe the cough.
- Practicing good hand washing.
- Drinking plenty of fluids, including water, juices, and soups, and eating fruits to prevent dehydration (lack of fluids). Report any signs of dehydration to your doctor immediately. These include dry, sticky mouth, sleepiness or tiredness, thirst, decreased urination or fewer wet diapers, few or no tears when crying, muscle weakness, headache, dizziness or lightheadedness.
- Eating small, frequent meals to help prevent vomiting if occurring.
If Your Child is Treated for Pertussis in the Hospital
Your child may need help keeping breathing passages clear, which may require suctioning (drawing out) of thick respiratory secretions. Breathing is monitored and oxygen will be given, if needed. Intravenous (IV, through the vein) fluids might be required if your child shows signs of dehydration or has difficulty eating. Precautions, like practicing good hand hygiene and keeping surfaces clean, should be taken.