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1993-06-14
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$Unique_ID{PAR00182}
$Pretitle{}
$Title{Medical Advice: Whooping Cough}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{strangling Whooping Cough Runny nose fever vomiting mucus immunized
contagious bacteria bacterial infections respiratory tract infection bacterium
Bordetella pertussis Bordetella parapertussis Bordetella bronchiseptica.
paroxysmal whoop immunity booster shot shots boosters immune immunized
immunization immunizations blood test tests cultures secretion secretions
throat culture antibiotics antibiotic erythromycin human antipertussis serum
serums}
$Log{}
Your Child: A Medical Guide
Whooping Cough
Quick Reference
SYMPTOMS
- Runny nose
- Low-grade fever
- Severe, strangling ("whooping") cough followed by vomiting of mucus
HOME CARE
- Isolate the child from other young children.
- If the vomiting is severe, feed the child several small meals a day,
rather than three large ones.
PRECAUTIONS
- Make sure that your child is adequately immunized against whooping
cough. It is especially important that all infants be immunized
because whooping cough in infants is often fatal.
- Whooping cough is more common than many parents and doctors believe,
and 90 percent of cases are never diagnosed.
- A child who has been exposed to whooping cough should be seen by a
doctor.
- A mild cough may indicate mild whooping cough, which the child can
spread to others.
- Any cough that is getting progressively worse after two weeks should be
brought to the attention of your doctor.
- Whooping cough is highly contagious. The infected child should be kept
away from other people.
- Whooping cough can be caused by three types of bacteria, and recovery
from one type does not confer immunity against the other two.
Whooping cough is a highly contagious infection of the respiratory tract,
usually caused by the bacterium Bordetella pertussis, but sometimes by
Bordetella parapertussis or Bordetella bronchiseptica. Whooping cough caused
by one type of bacteria does not provide immunity against whooping cough
caused by the other two types, and the vaccine that is available provides
immunity only against infection from the most common organism, Bordetella
pertussis.
The incubation period (the time it takes for symptoms to develop once the
child has been exposed to the disease) is seven to 14 days. Whooping cough
can be extremely serious in infants under one year; as many as 50 percent of
infants who contract whooping cough die. Newborns are not immune.
SIGNS AND SYMPTOMS
In a child who has not been immunized, the diagnosis is virtually
unmistakable. Whooping cough begins with a runny nose, a low-grade fever (100
degrees_F to 101 degrees_F), and a cough that gradually worsens over the
following two to three weeks. The cough then becomes characteristic: it is
worse at night than during the day, and it is paroxysmal (the child coughs
several times in succession without inhaling in between). At the end of a
coughing spell, the child makes a "whoop," or strangling sound, as air is
sucked into the lungs; vomiting of thick mucus follows. The severe,
strangling cough persists for another two to three weeks and gradually
subsides in three to six more weeks, but it may return with new respiratory
infections.
The diagnosis may not be obvious, however, in infants in whom the
characteristic "whoop" does not develop, and in an immunized child the
diagnosis may be impossible. (Remember that the child who has been immunized
may have only partial immunity, and that without boosters the immunity
declines over the years.) A child who is partially immune may have a mild case
of whooping cough that produces none of the identifiable symptoms of whooping
cough.
In the absence of the characteristic symptoms, laboratory tests do not
help much. The organisms that cause whooping cough are difficult to grow on
cultures. Because it may be difficult to diagnose and because many doctors
and parents mistakenly believe that the disease is rare, over 90 percent of
cases of whooping cough are never detected, or even suspected.
HOME CARE
A child who has whooping cough should be isolated from others, especially
young children. If the vomiting is severe, feed the child several small meals
a day, rather than three large ones.
PRECAUTIONS
- Make sure that your child is immunized against whooping cough. The risks
from the disease far outweigh the risks from the immunization. Infants
are not naturally immune to the disease, and the mortality (death) rate
among infants who contract whooping cough is high.
- A child who has a mild cough may have a mild form of whooping cough, in
which case he could spread the disease. Avoid unnecessary exposure to
others.
- If your child has been exposed to whooping cough, have him seen by your
doctor.
- Report to your doctor any cough that is getting progressively worse at
the end of two weeks.
MEDICAL TREATMENT
Your doctor will try to establish a diagnosis with the help of blood
studies and cultures of the secretions from the nose and throat. Most often,
however, diagnosis is based on the child's medical history and the doctor's
clinical judgment.
All infants with whooping cough are hospitalized. An older child may or
may not be, depending on his condition.
Your doctor may prescribe the antibiotic erythromycin for ten to 14 days
to make the disease less contagious. If given early enough, the medication
may shorten the course of the illness. If your child has been exposed to
whooping cough, he or she can be given erythromycin by mouth, a booster shot
of vaccine, or a large dose of human antipertussis serum.
RELATED TOPICS: Coughs; Immunizations; Vomiting