Pertussis

Causes

Pertussis is caused by specific bacteria. It is spread by:

• Inhaling droplets from the sneeze or cough of a person infected with pertussis
• Having direct contact with the mucus of a person infected with pertussis

Risk Factors

Factors that may increase the chances of pertussis:

• Not being vaccinated against pertussis
• Living in the same house or working in close contact with someone who has pertussis

Symptoms

Symptoms usually begin within a week or 2 after exposure.

Initial symptoms last about 1 to 2 weeks. They may include:

• Runny nose and congestion
• Sneezing
• Mild fever
• Mild cough
• Watery, red eyes

The second stage of pertussis is called the paroxysmal stage. This stage usually lasts 1 to 6 weeks, but can last much longer. Symptoms may include:

• Severe coughing
• Long episodes of coughing that start suddenly and may end with a forceful inhale or whoop sound (the sound does not occur in all people)
• In severe cases, coughing may cause a person to have trouble breathing or turn blue from lack of oxygen
• Coughing episodes may result in vomiting

During the final stage, the cough gradually improves over 2 to 3 weeks. Episodes of coughing can still occur during this stage.

Complications in infants and young children may include:

• Pneumonia
• Seizures
• Periods of no breathing
• Abdominal and inguinal hernias
• Brain damage (rare)
• Death (rare)

Complications in teens and adults can include weight loss and inability to control urine. Rarely, fainting or rib fractures can occur from severe coughing.

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The doctor may suspect pertussis based on symptoms. A swab from nose, throat, or blood may be tested to confirm the results.

Treatment

Treatment may include:

Medication

Pertussis is treated with antibiotics. This also keeps the infection from spreading. Antibiotics are most effective when started in the early stages. They will usually not improve the symptoms or otherwise affect the illness.

Treatment of Symptoms

Antibiotics or cough medicine will not prevent coughing. The following steps may help control symptoms and prevent problems:

• Plenty of rest.
• Cool mist vaporizer to loosen mucus and soothe the respiratory tract.
• Avoid irritants that trigger coughing, such as smoke or aerosol sprays.
• Plenty of fluids.

Hospitalization

Those with severe infections may need hospital care. People with pertussis are usually isolated to prevent spreading the disease to others.

Prevention

Vaccination

The best way to prevent pertussis is with a vaccine. Most children should receive the DTaP vaccine series. This protects against diphtheria , tetanus , and pertussis. Another vaccine called Tdap is routinely given to children aged 11 to 12 after they have completed the DTaP series of shots. There are also catch-up schedules for children and adults who have not been fully vaccinated. Td or Tdap boosters are given to adults every 10 years.

Pregnant women should have a dose of Tdap during every pregnancy to protect newborns from pertussis.

Preventive Antibiotics

People in close contact with someone with pertussis may be given antibiotics to prevent an infection. This is important in households with members at high risk for severe disease. Children under 1 year of age or people with weak immune systems have a higher risk of severe pertussis.