Whooping cough, also known as pertussis, is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis. Despite the availability of vaccines, pertussis remains a significant public health concern, affecting individuals of all ages but posing the greatest risk to infants and young children. With the recent uptick in pertussis-like illness cases in New Jersey, this article provides an overview of whooping cough, including its symptoms, treatment, and prevention strategies.
Symptoms of Whooping Cough
Whooping cough progresses through three stages, each characterized by different symptoms:
Catarrhal Stage:
- Duration: 1-2 weeks
- Symptoms: This initial stage resembles a common cold, with symptoms including a runny nose, sneezing, mild cough, and low-grade fever. The infection is most contagious during this phase.
Paroxysmal Stage:
- Duration: 1-6 weeks, potentially longer
- Symptoms: Severe and prolonged coughing fits are the hallmark of this stage. The coughs are rapid and consecutive, followed by a high-pitched "whoop" sound as the patient inhales. These coughing episodes can lead to vomiting, exhaustion, and difficulty breathing. Infants may not whoop but can experience apnea (pauses in breathing).
Convalescent Stage:
- Duration: 2-3 weeks
- Symptoms: The recovery phase involves a gradual reduction in coughing fits. However, episodes may recur with subsequent respiratory infections for months.
Treatment of Whooping Cough
Early diagnosis and treatment are crucial, especially for infants who are at higher risk of complications. Treatment options for whooping cough include:
- Antibiotics: Antibiotics such as azithromycin, erythromycin, and clarithromycin are prescribed to eliminate the Bordetella pertussis bacterium. They are most effective when administered during the catarrhal stage, reducing the severity of symptoms and preventing the spread of the disease.
- Supportive Care: Severe cases, particularly in infants, may require hospitalization for close monitoring and supportive care. This can include oxygen therapy, intravenous fluids to prevent dehydration, and medications to manage severe coughing fits.
- Hydration and Rest: Ensuring the patient stays hydrated and gets plenty of rest is essential for recovery. Small, frequent meals can help prevent dehydration and vomiting.
- Isolation: To prevent spreading the infection, those diagnosed with whooping cough should avoid contact with others until they have completed at least five days of antibiotic treatment.
Prevention of Whooping Cough
Vaccination is the most effective way to prevent whooping cough. Key preventive measures include:
- DTaP Vaccine (Diphtheria, Tetanus, and Pertussis): The DTaP vaccine is administered to children at 2, 4, 6, and 15-18 months, with a booster dose at 4-6 years of age. This vaccine provides immunity against diphtheria, tetanus, and pertussis.
- Tdap Vaccine (Tetanus, Diphtheria, and Pertussis): The Tdap booster is recommended for adolescents (11-12 years) and adults, particularly those in close contact with infants. Pregnant women are advised to receive the Tdap vaccine during each pregnancy, ideally between 27 and 36 weeks of gestation, to protect their newborns through passive immunity.
- Herd Immunity: Achieving high vaccination coverage in the community helps protect those who cannot be vaccinated, such as infants younger than two months and individuals with specific medical conditions. This community-level protection, known as herd immunity, reduces the overall spread of the disease.
- Public Awareness and Education: Raising awareness about the importance of vaccination and the potential severity of whooping cough can encourage higher vaccination rates and prompt diagnosis. Public health campaigns and educational programs are vital in promoting these messages.
Whooping cough is a severe and preventable disease. Recognizing the symptoms, seeking timely treatment, and adhering to vaccination guidelines are critical in managing and preventing pertussis. Through widespread vaccination and public education, the incidence of whooping cough can be significantly reduced, protecting vulnerable populations and ensuring healthier communities.
The contents of this article have been reviewed by Taylor Deleener MS, BSN, RN, CEN, CIC. Taylor is the Infection Prevention Manager at Shore Medical Center.
