The Complete Guide to Whooping Cough


Whooping Cough is a disease that has plagued humanity for centuries and at its worse, has claimed the lives of millions. In 2015 alone, whooping cough has accounted for the death of about 60,000 people, most of which were children. The illness was first recorded in the 16th century and it wasn’t until 1906 that the bacteria causing whooping cough was discovered. It won’t be until more than three decades later in 1940 that the vaccine for this illness is discovered.

Whooping cough or pertussis is a very contagious disease caused by the Bordetella Pertussis or Bordetella parapertussis bacteria. It’s an airborne disease which spreads easily through the sneezes and coughs of an infected person. People become infectious from the start of symptoms until about three weeks into the coughing fits. Anybody is susceptible to pertussis but younger children are prone to more serious conditions than older ones. Adults will generally display milder symptoms. Those treated with antibiotics are no longer infectious after five days.

A Short History of Whooping Cough

The most evident characteristics of whooping cough is the episodes of violent coughing. Transmittal is through the air where an infected individual can pass the disease through sneezing and coughing. The disease was named because of the characteristic sound produced when infected person attempts to inhale. The sound is caused by the inflammation and swelling of the larynx which tends to vibrate when there is a fast inflow of air during inhalation. The sound is hardly noticed in children but is more evident in older children and adults. Children are more likely to experience violent coughing episodes and at times can cause them facial cyanosis or blue skin coloration and at times, although rarely, apnea or a cessation of breathing.

Whooping cough has been a scourge of men since the 16th century. It was only in 1906 that the bacterium responsible for the disease was identified. Before the advent of the vaccine, there were over a quarter of a million cases in the USA, including 9,000 casualties. The vaccine was finally introduced in the 1940s in combination with diphtheria and tetanus toxoids (DTP).  By 1976, the incidences of whooping cough have decreased by more than 99%. There was a brief resurgence of whooping cough in the 1980s. The pertussis epidemic started to manifest itself every three to five years in the USA.

Some Important Facts About Whooping Cough

Whooping cough outbreaks can happen in any place and they can affect people of varying ages whether they’ve been vaccinated or not. A person can defend himself from whooping cough be acquiring the vaccine but even this isn’t 100% effective. Until babies reach 2 months, they’re highly susceptible to the disease and s they need to be protected from those who already have the disease. Although the vaccine can’t protect everyone, those who still get the infection would experience symptoms which are less severe. Also, those who have been vaccinated have a better chance of recovering from the illness at a faster rate.

Here are more facts about whooping cough to keep in mind:

Whooping Cough Is Considered as One of the Most Highly Contagious Diseases. After the incubation period, this disease becomes highly contagious. It gets transmitted through droplets in the air which are infected with the bacteria. When an infected person sneezes or coughs, they release these droplets which may potentially infect other people. The good news is that the disease can be treated using antibiotics if it is diagnosed in the early stage.

Whooping Cough Can Be Fatal. Whooping cough can be fatal for some people, particularly babies. This is because they might stop breathing, suffer from brain damage, develop pneumonia or even have seizures.

The Fits of Whooping Cough Can Be Intense and Uncomfortable. This infectious disease gets its name from the sound the infected people make as they gasp for breath during their coughing fits. The coughs keep coming and they won’t stop for around 15 seconds and up to a whole minute. For those experiencing the coughing fit, it seems like a much longer time. This is why the disease is a lot more dangerous for babies because they’re more helpless and they can’t control their bodies as well as kids or adults. However, younger babies don’t usually make the “whoop” sound between coughs. Instead, they experience severe breathlessness.

There Are New Strains of the Bacteria Which Cause Whooping Cough. As soon as the Bordetella pertussis bacteria gets into a person’s lungs, it sticks to the lining of the lungs and starts producing the pertussis toxin. Then the toxin starts to paralyze the cilia which are the small hairs in the lungs’ linings which move to help clear away any mucus through coughing. Just like other types of living things, the bacteria that causes whooping cough adapts and changes as time goes by. Because of this, new strains of the bacteria are emerging and those who develop the vaccine have to keep up if they want to provide protection to the people.

There Is an Increase in the Whooping Cough Cases in the Us. The first time immunizations came out, the cases of this disease dropped significantly. However, there has been an increase in the past few years in terms of local outbreaks and there have also been reports of state-wide epidemics. Although most of the reported cases were in kids, about a third of the infections were in adolescents and about a fifth of them were in adults.

Young People and Those Who Have Other Medical Conditions Have a Higher Risk of Whooping Cough. Just like any other illnesses, whooping cough affects people differently. The severity may depend on the strength of the person’s immune system and the person’s age. For instance, if it occurs in young people who don’t have fully-developed lungs yet, it can be more dangerous.

Practicing the “Cocoon Effect” May Help Protect Babies Better. If parents want to protect their babies, they can practice the “cocoon effect” wherein everyone around the baby should get vaccinated. This will protect the baby the most because the people around him won’t get infected and, in turn, won’t risk transmitting the infection to the little one.

Getting Vaccinated Is the Best Type of Protection Against Whooping Cough. A pertussis vaccine is generally considered safe and highly effective at preventing the infection. Usually, babies would start getting the vaccine at 2 months old he would receive a series of vaccinations as he grows older.

Even Teenagers and Adults Require Whooping Cough Booster Shots. Aside from babies, teenagers and adults need pertussis vaccinations too. This is because the vaccinations won’t protect the person permanently. Proof of this comes from the people who get infected with whooping cough even though they’ve acquired the vaccine already. If one wants to know when to get the vaccine and which booster shot to get, it’s best to ask the doctor.

Pregnant Women Need Vaccinations Too During Each Pregnancy. It’s especially important for pregnant women to get vaccinated in order to provide protection to their baby too. After the pregnant woman gets the vaccine, the antibodies get transmitted to the baby through her placenta which, in turn, protects the fetus that’s developing in her womb.

Causes and Risk Factors of Whooping Cough

Bordetella pertussis is the bacterium that’s responsible for whooping cough and, unfortunately, humans happen to be the only reservoir of this microorganism. It seems to have an affinity for humans because the bacteria can only survive in them. When inhaled, the bacteria attaches itself to the linings of the airways of the upper respiratory system where they start to release their toxins that will cause inflammations and swellings. As we have mentioned earlier, a person can be infected by breathing the bacteria through droplets released when an infected person coughs or sneezes.

Aside from coughing and sneezing, the bacteria can also be transferred through contact with surfaces which have been recently contaminated. The bacteria will thrive in one’s respiratory passages then they will start to release toxins that can cause damage to the small hairs or cilia lining the air passages. These cilia are important in removing cellular waste and foreign matter that enter into our airways when we breathe. When the cilia are damaged, there will be a greater chance of inflammation of a person’s airways and this will cause dry coughs, a primary symptom of infection. Pertussis is very contagious, starting from a week after getting exposed and up to three weeks after one starts experiencing the coughing spasms. The first stage of the disease is the most contagious period.

It was originally thought that whooping cough was a childhood disease, but later studies proved that adults are also prone to it as well and it accounts for about a quarter of the whooping cough cases. In adults, the disease is usually milder compared to a cough that’s persistent and caused by a common cold or a respiratory infection. Due to this assumption in adults, the diagnosis for the disease is often missed and, thus, will allow the bacteria to continue spreading to infants and young children who are more susceptible.

Just to reiterate, whooping cough is very highly contagious and between 75% to W100% or the members of a household are bound to acquire the illness if one member contracts whooping cough. Caregivers and family members who have the disease at its early stages are bound to infect infants even without realizing that they have the disease. Whether one has been immunized or has a natural immunity from whooping cough, living under one roof could still cause the spread of the disease following acute exposure.

Someone infected with whooping cough can easily spread the disease, starting at the time the symptoms appear until about three weeks when one starts having coughing episodes. Taking antibiotics will reduce the period of being contagious to around five days.

There’s nobody special when it comes to whooping cough. The disease will spare no one. The most common victims are young infants who have not been immunized or are incompletely immunized. They are the most vulnerable to infections and the various complications including seizures and pneumonia. In rare cases, they might also experience apnea or when one stops breathing. No country is also spared from a whooping cough epidemic, even those with vaccination programs that are well-developed. Adults who had immunity from their childhood vaccinations for whooping cough are also not safe because the effects of the vaccine will wear off.

The Stages and Symptoms of Whooping Cough

Whooping cough generally infects a person’s upper respiratory system, particularly where the back of the throat or the nasopharynx meets the nasal passages. The resulting infection brings about irritations in the airways that causes severe cough episodes. There are three stages of whooping cough which could last for months. If not properly taken care of, complications such as pneumonia can arise.

First Stage. The symptoms are similar to those of a common cold and this can persist from several days to two weeks. Sneezing, a runny nose, watery eyes, mild coughing, and a mild fever are the first symptoms. It’s here where the infected person is at his most contagious.

The first stage is known as the catarrhal stage characterized by a runny nose. The phase can last for up to two weeks. Most common symptoms one would experience while at this phase include sneezing, nasal congestion, intermittent coughing, and a runny nose.  For some people, a mild fever might be recorded too. It’s important to note that at this stage that the progression of the disease can be stopped by using antibiotics.

Second Stage. The second stage is referred to the paroxysmal stage and the length of this stage can vary from 1-10 weeks. The coughing here starts to become very intense and tends to occur during the night. The frequency of attacks averages about 15 times for every period of 24 hours. It’s at this stage where the “whooping” sound becomes more evident when the infected person gasps when inhaling between the coughs. This type of sound should not be confused with “a barking cough” which is more indicative of a viral infection. For infants and newborn babies who have been infected with whooping cough, they may seem that they’re not breathing and, on occasion, would start turning blue during their coughing episodes. Choking and vomiting are also expected at this stage.

The most severe symptoms happen during this paroxysmal stage and such can last from 2-4 weeks or even longer. As the cold-like symptoms cease, the coughing will get worse. The person’s dry and hacking cough can intensify then transform into uncontrollable and usually, violent coughing which can make it appear that breathing is impossible. The infected person, every chance he gets, will quickly inhale for a chance to breathe through airways that have been narrowed by inflammations. This creates that whooping sound.

Third Stage. This is also referred to as the convalescent stage and it may last for several weeks and even months. The stage is characterized by a chronic cough that is less paroxysmal in nature. This means there are now fewer coughing outbursts.

The convalescent period which can last from weeks to months is actually a slow recovery period. Here, the person will start to gain strength and will start feeling better. There will still be bouts of coughing that may get louder or sound even worse. Coughing episodes will become fewer but these can recur if a cold or some other respiratory illness should develop. This recovery period may last a bit longer for those who weren’t given the whooping cough vaccine.

Complications may also develop, brought about by the injuries from coughing which are exertion-related. Possible complications can include pneumonia and hernia. These become more serious if they should affect infants less than 4 months or adults 60 years old and above.

Diagnosis and Treatment of Whooping Cough

Many people in the medical industry have the knowledge on how to treat this condition. These include primary caregivers, family medicine specialists, pediatricians, internists, and even infectious-disease specialists. When a person displays symptoms of this condition, doctors can perform their diagnosis based on the person’s clinical history. The disease along with its symptoms and its severity may vary for each individual. If there should be some doubt about the diagnosis, a laboratory test can always be recommended by a doctor to confirm the diagnosis. If indeed, the diagnosis is whooping cough, a bacteria culture from one’s nasal secretions may confirm this. Another test that can be used to identify the bacteria is the polymerase chain reaction test or PCR. This test will identify any genetic material from the bacteria taken from nasal secretions.

The use of antibiotics against the bacteria can reduce the severity of the condition but only when given in the early stages of whooping cough. The use of antibiotics can also lessen the chances of spreading the bacteria to any members of the household or to any other person who may come in contact with the infected person. Antibiotics are very important as they can decrease the severity of whooping cough and make the infected person less contagious. They, however, need to be administered at the early stages of the disease. When using antibiotics, there are special precautions and recommendations that need to be followed:

  • Some strains of the Bordetella pertussis bacteria are resistant to certain antibiotics. In such cases, the symptoms may get worse.
  • In addition to treating the already infected adult and child, everybody in the household should also be treated prophylactically with antibiotics.
  • All close contacts younger than 7 years of age who have not yet completed their primary vaccinations should complete their series with the minimum time between shots.
  • All close contacts younger than 7 years of age who have completed their primary series but have not yet received their booster of DPT within three years of exposure should be given their booster shot.
  • Any adults exposed to the disease should be vaccinated with the Tdap.
  • Any infected person should be isolated for a minimum of five days after being administered with antibiotics or until three weeks after the beginning of the coughing spasms if the person has not yet received any antibiotic treatments.

It’s unfortunate that most of the persons who have been infected with whooping cough have been diagnosed in the second paroxysmal stage of whooping cough. Antibiotics are the most recommended form of treatment for those who have been suffering from whooping cough for less than three or four weeks. There are some antibiotics which have been used to effectively treat whooping cough. Using antibiotics on those who have been infected for more than three up to four weeks is still debatable. Many doctors believe the benefits of use after some time is questionable although some still recommend antibiotic therapy for the group.

Health care professionals and doctors administer antibiotics routinely to those who have come in close contact with infected individuals, even if they’ve been vaccinated. It’s important not to give children prescription or over-the-counter cough medications without instructions from the doctor. Such medications can lead to sedation that could lead to worse scenarios.

When to Seek Medical Care

Whooping cough can be serious, especially when it infects newborn babies and infants. If one thinks his child has the disease, it’s best to bring the child to the doctor immediately. Remember, the earlier the disease is diagnosed, the better for the child, the mother, and the rest of the household. Every mother should know the tell-tale signs of the disease so they can be best prepared when and if the disease touches home-base.

When should one call the doctor?

  • If the person suspects, through the symptoms, that the child has the disease.
  • If the child was exposed to an infected person. This applies whether the child already had immunization shots or not.
  • If the child gets a fever which can’t be managed by over-the-counter medications.
  • It the child vomits and cannot keep liquids and solids down.

When should one bring the child to the hospital?

  • If the child’s breathing stops. Immediately call 911 (or other emergency services) then start performing CPR.
  • If the child’s face starts turning blue during coughing spells.

Also, go to the Emergency Department if a person infected with the disease is showing specific symptoms including:

  • An inability to keep liquids down.
  • Unmanageable fever even when using medications.
  • Symptoms of respiratory difficulty such as turning blue or rapid breathing.
  • Signs of dry mucous membranes, dehydration, weight loss or a decrease in urine output.

Some Home Remedies for Whooping Cough

Since young children are more susceptible to developing severe cases of this disease than adults, it’s more likely to see more of them admitted to hospitals. There are, however, certain tips to effectively manage whooping cough in the comforts of home after the doctor’s diagnosis of whooping cough:

  • Separate the infected person after receiving a 5-day treatment of antibiotics. Everybody who needs to come in contact with the infected person should have a surgical mask over his face. At times, persons who come in contact with the infected person should be prescribed the appropriate antibiotics as well to prevent further spread of the disease.
  • Wash hands regularly. Contaminated materials can also be an agent in transmitting whooping cough. Always wash hands thoroughly when coming in close proximity to the infection, either that be a person or some contaminated inanimate material.
  • For the infected individual, drink a lot of fluids such as soups, juices or water and eat a lot of fruits too in order to avoid dehydration.
  • Eat small but frequent meals in order to avoid vomiting.
  • Keep a cool-mist vaporizer which can help loosen any secretions and help soothe coughing.
  • Clean the environment to make it free from any irritants which can induce coughing just like fumes, smoke, and aerosols.
  • Keep a close monitor on children for any symptoms of dehydration. Some of these signs include dry mouth, dry skin, dry tongue and lips, a reduction in the number of wet diapers, in the amount of urine, and more. If these happen, inform the doctor immediately.
  • Don’t give cough medicines or any other kinds of home remedies without the approval of the doctor first.

An infected person can also take foods to enhance the treatment of the condition. These can include the following:

Garlic. This is one of the best natural remedies in the treatment of whooping cough. A syrup of garlic is given in doses of 5 drops about 2-3 times daily. Add the more dosages if coughing episodes become frequent and more violent.

Ginger. This is another natural remedy. Mix a teaspoon of ginger juice with a cup of fenugreek decoction then add some honey to taste. This is an excellent diaphoretic.

Almond Oil. Try this for whooping cough. Mix 5 drops of almond oil with 10 drops each of white onion and ginger juice. Take this three times daily for a fortnight. It will give relief.

Calamus. This herb is also valuable in providing relief from whooping cough. A pinch of the powder of the roasted herb should be taken with a teaspoon of honey. Having antispasmodic properties, the herb will prevent severe bouts of coughing. If given to smaller children, the dose should be proportionally smaller.

Follow-Up for Whooping Cough

Since whooping cough has been repeatedly mentioned as a very contagious disease, daycare centers and schools should be immediately notified in case of incidents. Children who should develop coughs must be checked by doctors for the possibility of the disease. Those less than 7 years old, attend daycares or schools, and haven’t had all their vaccinations must immediately receive them. Here are important points that need to be considered in terms of follow-up for this condition

  • Children who have been diagnosed with mild whooping cough can go back to the daycare or to school after taking antibiotics for a specific number of days.
  • Risk factors for contracting whooping cough are direct exposure to the sneeze or cough of an infected person or touching any surfaces that have been recently used by the infected person.
  • Using a surgical mask and frequent washing of hands can reduce the likelihood of the pertussis bacteria getting transmitted to other people in the environment.
  • Avoid touching the mouth or nose. This may be the entry point of the bacteria in case one might have picked it up during an outbreak.

Vaccine for Whooping Cough

Parents must see to it that their children stay on the recommended schedule of the vaccine for the DTaP inoculations. These shots are typically administered when the child is at 2, 4, and 6 months. Then again when the child is at 15-18 months and finally, when aged 4-6 for the full immunity. It should also be noted that the vaccine’s immunity will generally wane after 6-10 years and doesn’t cover permanent immunity.

Adults, adolescents, and older children can contract the disease again and will need revaccination. Although adults get milder forms of pertussis, it’s still imperative that they get vaccinated as well because they can spread the disease to their children or other members of the household. People who have received the whooping cough vaccine can still contract the disease but they will have lower risks of experiencing complications and may experience symptoms which are less severe. Most of the time, the cough’s duration is shorter, the coughs aren’t as frequent, and they’re less intense compared to unvaccinated people.

FAQs About Whooping Cough

What does one need to know about whooping cough? We already know that it’s a highly contagious disease, it’s caused by the bacterium Bordetella pertussis and that it’s more serious when newborn babies and infants are infected. The disease is characterized by cold-like symptoms which become more intense after a few weeks. It’s recommended to see the doctor if one believes he has the disease, the sooner the better to be able to stop the disease at its tracts with the help of antibiotics. Here are some FAQs about the disease:

How Long Is the Incubation Period of This Illness? The incubation period or the period from exposure to the development of symptoms is usually longer than that of the common cold or some other respiratory diseases. In general, symptoms start to manifest themselves within 7-10 days after exposure. Some of the symptoms may not even appear for up to three weeks after the initial infection.

How Long Does It Last? It may take up to three weeks for symptoms to appear but on the average, the symptoms develop within 7-10 days after getting infected. The paroxysmal stage where the symptoms are at their worst usually last from 1-6 weeks but some cases lasted for 10 weeks. The final stage can last from 2-3 weeks.

What Does It Sound Like? The whooping cough sounds predominantly occur during the paroxysmal stage of whooping cough. One would have a series or a burst of rapid and violent coughs. After each cough, along breathing in of air usually comes with a high-pitched whooping sound for which the disease got its name.

How Is the Disease Transmitted? Whooping cough is a highly contagious disease that can spread among people through direct contact with the fluids from the mouth and nose of an infected person. The disease could also be transmitted through droplets from infected persons, expelled when they sneeze and cough. People can contaminated their hands by touching respiratory secretions from infected people then touching their own mouths and noses.

Can Adults Get It Too? Yes. Adults can also catch whooping cough even if they received vaccinations when they were children. This is because the immunity for pertussis has an expiration date, meaning the immunity decreases as time goes by. There will always be a certain level of immunity against whooping cough but the results are milder in adults. Even if the symptoms in adults are milder, the duration of the paroxysmal coughs can last just as long as in children. Still, children are the more vulnerable victims of whooping cough.

Whooping cough in adults usually accounts for 7% of adult diseases which cause coughing every year. Although mild in adults, they become reservoirs of infection for kids. It is, therefore, imperative that all the caregivers and family members of young children should receive whooping cough vaccinations.

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