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Pertussis (Whooping cough)

What is pertussis?

  • Pertussis, or whooping cough, is an infection of the respiratory tract caused by bacteria called Bordetella pertussis.
  • Although vaccination has contributed to the marked decrease in the frequency of this disease, thousands of cases still occur every year in the United States.
  • Pertussis is most severe in infants under 1 year old.

How does a child get pertussis?

  • As with many respiratory tract infections, pertussis is spread by respiratory droplets from an infected person’s nose or mouth after they sneeze or cough.
  • The droplets are spread through the air and breathed in by a child.

How long will it take my child to become ill after being exposed to someone else with pertussis?

  • Remember, just because your child is exposed to an ill person does not necessarily mean they too will become ill.
  • But if your child is to become ill, it usually takes 7 – 10 days after exposure, although it may take as long as 21 days.

What are the signs and symptoms of pertussis in children?

  • In the beginning of the illness the child usually develops cold symptoms (e.g., congestion, runny nose)
  • Severe and rapid coughing spells develop 1 to 2 weeks after the cold symptoms start.

o       This stage of the disease usually lasts 2 to 4 weeks, but can last longer.

  • After the cough the child breathes in suddenly and deeply which results in the whooping sound followed by another coughing spell.

o        The whoop may not always be present, especially in infants less than 6 months

  • Other symptoms may include vomiting during the coughing spells
  • Fever may be absent or just low-grade
  • The child’s lips may turn blue during the coughing spells because of a lack of oxygen

Are there any possible complications from pertussis in children?

  • Seizures
  • Apnea
  • Pneumonia
  • Infection of the brain (encephalopathy)

How can pertussis be diagnosed?

  • Culture for Bordetella pertussis requires a collection of a small amount of nasal secretions.
  • Because laboratory confirmation of pertussis is difficult, your doctor may rely on your child’s signs and symptoms and white blood cell count to make the diagnosis.

What is the treatment for pertussis?

  • Small frequent feedings to minimize vomiting
  • Infants less than 6 months often require hospitalization to monitor for apnea and manage feeding difficulties and other complications.
  • Antibiotics given early may lessen the severity of the infection. Antibiotics also may limit spread to other people.

o        Erythromycin for 14 days, clarithromycin for 7 days, or azithromycin for 5 days are the drugs of choice.

o        Erythromycin given to infants less than 2 weeks of age has been associated with pyloric stenosis, one form of intestinal blockage.

How long will my child be sick with pertussis?

  • After the coughing stage has passed the child usually recovers gradually over 2 to 3 weeks.

When can my child return to daycare or school?

  • A child with pertussis can give the disease to another child from the time they develop the cold symptoms until about 3 weeks after the severe coughing starts.
  • A child with confirmed pertussis should be excluded from daycare or school until 5 days of antibiotic therapy is complete or 3 weeks has passed from the time the cough began. 

When should I call my pediatrician concerning pertussis in my child?

  • It is best to call for specific instructions when you first suspect that your child has pertussis.
  • You should also call your doctor anytime your child’s illness is worsening, particularly any trouble breathing or turning blue, or if any complications arise such as seizures.

How can pertussis be prevented?

  • Children should get 5 doses of DTaP vaccine, one dose at each of the following ages:
  • 2 months
  • 4 months
  • 6 months
  • 15-18 months
  • 4-6 years

Recommendations for persons in close contact to an infected person to lessen the risk of infection

  • Close contacts < 7 years of age who are unimmunized or who have received fewer than 4 doses of pertussis vaccine should have pertussis immunization started or continued according to the recommended schedule.
  • Erythromycin, clarithromycin, or azithromycin is recommended for all household contacts and other close contacts, such as in daycare, regardless of age and immunization status