American Medical Association Family Medical Guide - American Medical Association [216]
Whooping Cough
Whooping cough (also called pertussis) is a serious bacterial infection of the respiratory system caused by the bacterium Bordetella pertussis, which makes the air passages become inflamed, narrowed, and clogged with thick mucus. The infection is spread by inhaling droplets that have been sneezed or coughed into the air by an infected person. The severe coughing bouts that are characteristic of the infection, which can cause permanent damage to an infant’s lungs or brain, are the body’s attempts to clear the lungs of mucus. Young infants (6 months old or younger) can contract the disease from adolescents or adults who have not been vaccinated or whose vaccine protection has weakened over time.
All children are required to be vaccinated against whooping cough (in a combined vaccine with diphtheria and tetanus) starting at 2 months of age, and four more times up to age 6. A child who has been immunized against whooping cough may still develop a mild case of the infection. Having had whooping cough once does not provide lifelong immunity.
Symptoms
The early symptoms of whooping cough are coldlike symptoms, including a runny nose, dry cough, and slight fever. Unlike a cold, however, the symptoms worsen after a few days. The nasal discharge thickens, and the coughing becomes more severe, occurring in episodes lasting up to 1 minute. During a bout of coughing, a child’s face turns deep red, or even blue, from lack of oxygen. At the end of each coughing episode, as the child gasps for air, he or she makes the whooping sound that gives the disease its name. Infants with whooping cough tend to whoop more quietly than older children, or may not whoop at all.
WARNING!
Don’t Give Cough Medicine for Whooping Cough
Do not give over-the-counter cough medications to a child with whooping cough. Your child needs to cough to prevent mucus from clogging his or her airways. Some over-the-counter cough medications contain ingredients that can suppress the cough and cause the airways to become blocked with mucus. If your child has a severe cough, talk to your doctor before giving him or her any medication.
After a bout of coughing, the child often vomits. The severe coughing phase of the disease can last from 2 to 10 weeks. Gradually the coughing and vomiting become less severe and less frequent, although a mild cough can persist for several months.
If your child has symptoms of whooping cough or has a cough that does not clear up within a few days and seems to be getting worse, talk to your doctor. If your child has symptoms of whooping cough, turns blue around the mouth or at the fingertips during a bout of coughing, or has difficulty breathing, call 911 or your local emergency number, or take him or her to the nearest hospital emergency department immediately.
Diagnosis
A diagnosis of whooping cough is based on a child’s symptoms and the results of a physical examination. The doctor may order a blood test or a microscopic examination of secretions from the child’s nose and throat to check for the infection-causing bacteria. He or she may recommend X-rays of the lungs to confirm the diagnosis. An infant with whooping cough may need to be hospitalized so the doctor can evaluate the severity of the disease and monitor it.
Treatment
To treat whooping cough, a child may need to be hospitalized and isolated from other children for a few days to help prevent the infection from spreading. Doctors monitor the child’s breathing, suction out any secretions that are blocking the airways, and prescribe antibiotics to kill the bacteria. In some cases, doctors recommend supplemental oxygen to assist breathing and intravenous fluids to prevent dehydration.
When caring for your child at home, have him or her rest in bed. The doctor probably will recommend using a cool-mist vaporizer in the child’s room at