Whooping Cough (Pertussis) – What Parents Should Know

Whooping Cough (Pertussis) is a lesser known ailment to many people. Yet, it is a serious condition with serious consequences. That is precisely the reason the TDaP (Tetanus, Diphtheria and Pertussis) vaccine is given to infants in multiple doses. Pertussis is the technical name for whooping cough.

Causes

The technical name pertussis comes from the fact that this condition is caused by a bacteria called Bordetella pertussis. The common name comes from the fact that a whooping sound is heard when the person inhales after a cough. Infants or growing children often get this condition from other children, older siblings, parents, caregivers, or other adults they come in contact.

While contagiousness is one reason, more realistic causes for a whopping cough outbreak are lack of awareness about the condition, wrong perceptions or sentiments around vaccination, and immunization programs that are not hygienically managed. People should be aware of these risks to prevent their children from getting infected by the condition.

Spread

Pertussis or whooping cough is highly contagious. If there is a person infected with the condition living in a house, there is an 80% chance of everybody else in the house being infected. Similar to the COVID-19, tuberculosis, and measles, the bacteria spread through droplets of saliva and mucous when the infected person coughs, sneezes, talks, or merely breathes in one’s presence. The bacteria can cling to their hands or surfaces the person touches. Thereafter, when the person touches his/her nose or mouth, the bacteria is inhaled or ingested into the body.

A person infected with pertussis is contagious for up to 5 weeks once the condition is detected and if no treatment is provided. However, once antibiotics are started, the person is not contagious after 5 days.

Symptoms

Most symptoms are similar across age groups, but there can be some unique symptoms too.

Infants:

• Gasping for breath
• Breathlessness or stopped breathing (sleep apnea)
• Reddish face
• Pneumonia
• Middle ear infection

Older babies and growing children

Typical symptoms of a cold such as

• Runny nose
• Mild and dry cough in the 1st week
• Low fever
• Watery eyes
• Sneezing fits
• From 2nd week onwards:- long coughing spells that get worse at night. with a whoop sound while inhaling after the cough
• Reddish or purplish face
• Vomiting
• Extreme fatigue
• Difficulty catching breath after the cough
• Diarrhea
• Lack of appetite

Teens and adults

• Same as above. Except that the coughing fits may be longer, more intense, and painful

Complications

If pertussis is ignored or wrongly diagnosed, the condition can worsen, creating many life-threatening complications.

Infants and growing children

The incessant coughing can prevent proper breathing and adequate oxygenation. This can cause:

• Seizures
• Pneumonia
• Apnea (slowed or stopped breathing)
• Brain damage
• Bleeding in the brain
• Convulsions (uncontrollable, rapid shaking)
• Death

Inability to eat or drink normally can cause dehydration, the symptoms of which are:

• Increased thirst
• Dry lips and mouth lining
• Tiredness
• Sunken eyes
• Irritability
• Dry skin
• Infrequent urination, low urine output

Teens and Adults

• Pneumonia
• Difficulty sleeping
• Urinary incontinence or loss of bladder control
• Broken or bruised ribs
• Abdominal hernias
• Broken blood vessels
• Trouble sleeping

Diagnosis

The doctor will conduct one or more of the following:

• Physical examination: This will look for all the tell-tale signs on the face along with checking vitals like pulse, BP, and heart-rate
• Medical history: This will assess recent respiratory infections if any, contact with infected people in the recent past, etc.
• Nose or throat swabs: The swab looks for presence of the bacteria that causes the condition
• Blood test: A high white-blood-cell count is a sign that the body is fighting some infection such as whooping cough.
• Chest X-ray: This looks for inflammation or fluid in the lungs, which are signs of pneumonia

Treatment

• Considering it’s a bacterial infection, antibiotics is the first and preferred mode of treatment
• IV fluids in case of dehydration
• Nasal drops
• Plenty of rest

Home care tips (after discharge from hospital)

• A humidifier or cool-mist vaporizer must be kept in the child/adult’s room to reduce the symptoms of pertussis
• Smoking, lighting agarbathis or using room perfumes must be avoided as the aerosols created by them can irritate the nasal cavity. The air must be kept as clean as possible
• The person must eat small meals to reduce the risk of vomiting
• Do not use cough medicines or expectorants as they are not effective

Prevention

Whooping cough can be fatal, so it’s important to do everything possible to prevent it in the first place

• Immunization: Vaccinating your child as per the prescribed schedule is very important. This includes the Tdap vaccine that is given for infants at 2 months, 4 months, and 6 months, with booster shots given to growing children at 15 to 18 months, 4 to 6 years, and again at 11 years of age.
• Cocoon vaccination: Parents, grandparents, teachers, caretakers, and all those adults who come in close or daily contact with children should get the adult vaccine for pertussis. This creates a ‘cocoon of safety’ around the child.
• Adult vaccination: Adults who work with, visit, or care for infants and children, as in the case of healthcare workers, as well as seniors (over 60 years of age) must also get the adult vaccine for whooping cough. This will prevent them from catching the infection and spreading it to others. In fact, in countries like the US and Canada, the health authorities and doctors recommend that all adults get a vaccine shot for pertussis.
• Appropriate behavior: Just like with COVID, infected children or adults should wash their hands as often as possible. They must cover their mouth and nose while sneezing, coughing, or talking. The use of a mask is highly desirable in such cases.

Outlook

Whooping cough is preventable and curable. If you or your dear ones are showing the above symptoms, do not dismiss them as normal cold or flu. Rush them to a reputed hospital where specialist doctors will diagnose the condition precisely and start a course of treatment for quick recovery and rehabilitation.

 

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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