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Whooping Cough (Pertussis)

What is whooping cough (pertussis)?

Whooping cough is a very contagious disease that can affect persons of all ages. It is caused by a bacterium called Bordetella pertussis and is spread through the air by respiratory droplets. The bacteria are found in the mouth, nose and throat of infected persons. Historically, whooping cough was a major problem and led to thousands of deaths in the 1930s and 1940s. With the advent of the pertussis vaccine, the rate of death has declined dramatically. Unfortunately, recent epidemics have emerged in areas where vaccine rates have fallen.

Currently, pertussis activity has increased throughout the United States. According to the CDC, more than 17,000 cases of pertussis were reported through July 12, 2012, with 9 pertussis-related deaths. Rates of pertussis in our local area have also reached epidemic levels.

Facts about whooping cough:

What are the symptoms of whooping cough?

The disease usually takes one to three weeks to develop, then progresses through three stages. The following are the most common symptoms of whooping cough, according to each stage. However, each child may experience symptoms differently. Symptoms may include:

The symptoms of whooping cough may resemble other medical conditions. Always consult your child's physician for a diagnosis.

How is whooping cough diagnosed?

In addition to a complete medical history and physical examination, diagnosis of whooping cough is often confirmed by testing secretions taken from the nose or throat.

Treatment for whooping cough:

Specific treatment for whooping cough will be determined by your child's physician based on:

In many cases, the child may be hospitalized for supportive care and monitoring. Sometimes, oxygen and intravenous (IV) fluids are needed until the child begins to recover. Antibiotic treatment (i.e., clarithromycin [Biaxin®] or azithromycin [Zithromax®], or a related antibiotic) may also be ordered by your child's physician. It is important to follow the schedule for giving medications exactly as your physician prescribed.

Family members and other people who have been in close contact with the child usually are started on antibiotic therapy, regardless of whether they have received the vaccine or not.

Other treatment may include the following:

Call your doctor or nurse practitioner if your child:

Get medical attention immediately if your child:

Prevent the spread of whooping cough. It is important to always practice good hand washing and cough etiquette. Children who are not vaccinated against whooping cough are eight times more likely to become infected than those who are vaccinated. The best way to prevent whooping cough is by making sure your family is vaccinated. There is a vaccine available for both children and adults against whooping cough.

Protection from pertussis through vaccination is provided by the DTaP vaccine - which stands for diphtheria, tetanus, and pertussis. This vaccine is usually given to children at 2, 4, 6, and 15 to 18 months of age, with a booster at 4 to 6 years of age. The acellular pertussis vaccine now recommended produces fewer adverse reactions than the older vaccine. Because immunity from the pertussis vaccination wears off after 5 to 10 years, a vaccination booster, called Tdap is recommended for adults.

More information on the vaccine is available on the CDC website and the CHOP Vaccine Education Center.

When can my child return to school or daycare after infection with pertussis?

If your child has been diagnosed with whooping cough, he or she cannot return to school/daycare until the prescribed medication course has been completed. Once completed, your child will no longer be infectious or capable of spreading the disease. However, your child’s cough may continue for up to 10 weeks or more.

Additional resources are available on the CDC Website, and a Parent Information Flyer.
 

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