Southeast Iowa Family Medicine and Allergy Associates: Your Health: Whooping Cough

Your Health

Whooping Cough (Pertussis)

The course of whooping cough is divided into 3 stages. The first stage of whooping cough is the catarrhal stage. This phase typically lasts 1-2 weeks. Symptoms during this phase resemble that of an upper respiratory illness; runny nose, nasal congestion, sneezing, and occasional cough. A low-grade fever may be seen in some cases as well.

The second stage of whooping cough is the paroxysmal stage. The duration of this stage is highly variable lasting between 1 and 10 weeks. In this stage intense and drawn out bouts of coughing begin. The attachks tend to be more frequent at night, with an average of 15 attacks in a 24-hour period. Often a "whoop" can be heard caused by the gasping person inhaling between coughs. Vomiting is also common.

The third stage of whooping cough is the convalescent stage. It can last for weeks or months and is characterized by a chronic cough that becomes less paroxysmal (fewer sudden outbursts of coughing) in nature.

Call a doctor if you suspect you or your child has whooping cough or if your child has been exposed to someone with whooping cough. Also seek medical attention if your child turns blue during a coughing spell, or if your child is unable to keep solids and liquids down, or if your child has a ver that cannot be controlled with over-the-counter medication.

If someone with diagnosed whooping cough shows any of the following symptoms, he or she should go to the hospital's emergency department.

Unable to tolerate liquids (vomit)
Uncontrolled fever even with antifever medications
Signs of respiratory distress including rapid breathing and turning blue
Signs of dehydration, including weight loss, dry mucous membranes, and decreased urine output

The best way to diagnose whooping cough is by confirming the presence of of the specific disease causing bacteria, Bordetella pertussis, in mucus taken from the nose and throat.

Laboratory methods used to diagnose pertussis are available usually involving a thin swab to obtain material from the nasal passage.

Antibiotics are used to lessen the severity of whooping cough and make the person taking them noncontagious. Some strains of whooping cough are resistant to certain antibiotics. Symptoms would get worse if this were the case. In addition to treating the adult or child who has whooping cough, everyone in the household should be treated with antibiotics as well.

Because younger children are at higher risk to develop a severe case of whooping cough than adults are, most are admitted to the hospital after being diagnosed. For children and adults who do not require hospitalization, here are some tips to manage the disease at home after diagnosis.

Isolate the person (separate bedroom) until he or she has received 5 days of antibiotics. During this time, everyone who comes into contact with the sick person should wear surgical masks to cover their faces.
Practice good handwashing skills. Whooping cough bacteria can be transmitted through contact with contaminated inanimate objects such as dishes.
Drink plenty of fluids, including water, juice, soups and fruits to prevent dehydration.
Eat small, frequent meals to decrease the amount of vomiting.
Do not give cough medications unless otherwise instructed by your doctor.
Use a cool mist vaporizer to help loosen secretions and soothe the cough.
Keep the home environment free from irritants that can trigger coughing, such as smoke, aerosols and fumes.