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What is Whooping Cough?

Whooping cough, or pertussis, is a very contagious and serious respiratory infection.  Fortunately, due to pertussis being included in routine vaccination schedules, the incidence of this infection in young children is significantly lower now.  

What Is Pertussis?

Pertussis is an infection caused by the bacterium Bordetella pertussis.  It is a highly contagious infection that is spread by respiratory droplets from coughing, sneezing, or being in close quarters with an infected individual.  

Once the bacteria get into the throat and lungs, it gets difficult to clear mucous from the airways.  This is the cause for the characteristic cough that is heard when an individual has a pertussis infection.

Symptoms of Pertussis

There is a characteristic cough in those affected with pertussis.  The coughing is often severe enough that it is hard to catch a breath between bouts of coughing.  In between coughing spells, a person with pertussis will inhale deeply and quickly – this makes the characteristic “whooping” sound.  

It will usually start out like the common cold, with a very runny nose.  Fever is not commonly seen.  Within a week or two, the cough will get worse.  The whooping cough phase can last a several weeks or more.  It can sometimes be known at the “cough of 100 days” because it can last for so long.  

Infants and children can be so short of breath and coughing so hard that they may appear blue around the mouth, or vomit from coughing.  

Infants Are At High Risk For Complications

Infants can become so exhausted from coughing that they can stop breathing for periods of time or have seizures.  Babies are at risk of other infections like pneumonia if they have pertussis.  Most often babies under the age of 1 will be hospitalized.  Death can occur in the youngest of infants, usually those less than 6 months old.

Prevention

The best way to prevent pertussis is with vaccination. Pertussis vaccine is typically administered as a combination vaccine called Tdap or dTap.  This vaccine contains tetanus toxoid, diphtheria toxoid and the acellular pertussis vaccine.  A typical routine vaccination schedule sees this administered to infants at 2, 4, and 6 months of age.

In recent years, Canada and the USA have seen a significant increase in the number of pertussis cases. There is now a recommendation by the Center of Disease Control and Prevention (CDC) to provide immunization to pregnant women for each pregnancy. The purpose of providing the pertussis vaccine to pregnant women is to protect newborn infants in Canada from severe outcomes of pertussis infection until they can receive their own vaccines starting at 2 months of age.  

Treatment of Pertussis

Antibiotics are prescribed to treat the bacteria and help prevent the spread to other people.  Unfortunately, antibiotics do not make the cough go away.  Your doctor will give you some tips for alleviating some of the cough symptoms.  Cough medicines are not effective and should not be used in children under the age of 6. 

This post was co-authored by Erin Manchuk, BScPharm, BCGP and Stephanie Liu, MD, MSc, CCFP, BHSc.

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