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Pertussis Whooping Cough

Pertussis – also known as whooping cough – is a contagious infection of the respiratory tract (breathing tubes). It causes severe coughing that can last for weeks. People with pertussis often make a loud “whooping sound” when they inhale after coughing.

Most cases of pertussis can be prevented by a vaccination (shot).

Anyone can get pertussis. It adversely affects infants younger than 6 months old before they’re fully protected by immunizations, and youth 11 to 18 years old whose immunity has started to fade. The disease can be very serious in very young children and infants. Pregnant women in their third trimester and adults over the age of 60 also have higher risk for complications. With good care, most people recover from pertussis with no problems.

Pertussis is caused by a type of bacteria called Bordetella pertussis. The disease is highly contagious. The bacteria spread easily through the air from person to person through tiny drops of fluid from an infected person’s nose or mouth. When an infected person sneezes or coughs others can become infected when they inhale the drops or get the drops on their hands and then touch their mouths or noses.

The best way to prevent pertussis is to get vaccinated. There are vaccines for infants, children, preteens, teens and adults. The pertussis vaccine is part of the DTaP (diphtheria, tetanus, acellular pertussis) immunization. DTaP immunizations are given in a series of doses before a child’s sixth birthday. Teens ages 14 to 16 and adults need one booster shot. This booster shot is very important for anyone who is in close contact with babies younger than one year old. Talk to your healthcare provider about getting vaccinated against pertussis.

Washing your hands often and staying away from people who are sick can also help you avoid catching pertussis.

Symptoms of pertussis begin within one to two weeks of exposure to the bacteria. At first a pertussis infection can seem like a common cold. Early symptoms can include:

  • runny nose
  • sneezing
  • cough
  • fever

After about one to two weeks, coughing can become severe. Often the cold symptoms disappear and severe and frequent spells of coughing begin. The cough can last for 10 weeks or more. Coughing can become so violent and frequent that you are forced to inhale with a loud “whooping” sound.

Many infants and younger children who become infected with pertussis will develop coughing spells and the common “whooping sound” as they inhale – but not in all cases. Infants may look as if they’re gasping for air. Their faces may also become very red. They may stop breathing for a few seconds during severe spells.

It’s important to see your healthcare provider if you suspect that your child has pertussis or has been exposed to someone with pertussis, even if your child has already received all scheduled pertussis vaccinations.

Adults and teens with pertussis may have milder symptoms, such as a long-lasting cough (rather than coughing spells) or they may cough without the whooping sound.

Call your healthcare provider if you think that you or your child has pertussis.  Your healthcare provider will take a medical history and do a physical exam.  Your healthcare provider may take a sample of mucus from the nose or throat and have it tested for the bacteria that cause pertussis. Blood tests and a chest X-ray may also be done.

Your healthcare provider may treat pertussis with antibiotic medication. If you or your child has it and has been put on antibiotics, it’s important to stay at home until the antibiotic has been taken for at least five days.

Ask your healthcare provider if preventive antibiotics or vaccine boosters for other family members are needed.

Treatment at home

If you or your child is being treated at home, follow the schedule for giving antibiotics exactly as prescribed. Cough medicines are not recommended and have not been shown to help pertussis. (Due to potential side effects, cough medicines are never recommended for children under age 6.)

During recovery, it’s important to rest and drink plenty of fluids. Keep your home free of irritants that can trigger coughing spells, such as cleaning products, aerosol sprays, tobacco smoke, and smoke from cooking, fireplaces, and wood-burning stoves.

Children with pertussis may vomit or not eat or drink much because of the coughing. Offer smaller, more frequent meals and encourage your child to drink lots of fluids. Watch for signs of dehydration and know the warning signs for pertussis complications. 

Many infants who get pertussis must be hospitalized. In rare cases it can be life threatening. Some of the complications for young infants and children can include:

  • vomiting after a coughing spell
  • weight loss
  • breathing problems
  • choking spells
  • pneumonia
  • convulsions
  • brain damage

When to call your healthcare provider?

Your child should be seen by a healthcare provider immediately if you think your child has pertussis or has been exposed to someone with pertussis or if he or she experiences any of the following warning signs:

  • long-lasting coughing spells that make your child’s skin or lips turn red, purple, or blue
  • coughing followed by vomiting
  • whooping sound when your child breathes in after coughing
  • difficulty breathing or brief periods of not breathing (apnea)
  • lethargy (no energy)
  • not drinking enough fluids (hasn’t passed urine) in many hours, or has no tears when he/she cries

In older children and adults, the disease is usually less serious, and complications are rare. The only sign of infection may be a bad cough that lasts longer than a week. Older members of a household may have pertussis without knowing it. This can be a serious risk to younger children and infants in the home who are unvaccinated, or who haven’t yet completed their full schedule of vaccinations.

Is the pertussis vaccine safe?

The vaccine is safe. Serious side effects are very rare. The vaccine used in Canada prevents the disease approximately 85% of the time. If a vaccinated child does get whooping cough infection, the disease will often be far less severe due to protection from the vaccine.

The vaccine to protect against whooping cough is provided free to all young children in Canada as part of the publicly funded routine immunization schedule. It is usually given by a needle or shot in combination with other childhood vaccines. To be fully immunized, a child needs five doses of whooping cough vaccine, starting at two months of age.

Call your healthcare provider or local health unit right away if you or your child has trouble breathing, a high fever, or anything unusual after having the shot.

What are the side effects of the vaccine?

Mild reactions one to three days after the DTaP shots are common, especially after the 4th and 5th doses. Common reactions include:

  • fever
  • redness or swelling where the shot was given
  • soreness or tenderness where the shot was given
  • tiredness/fussiness
  • loss of appetite

Why do I need a pertussis booster?

The protection against diphtheria, tetanus and pertussis wears off over time, which is why booster shots are recommended. Talk to your healthcare provider about the pertussis booster.

Where can I get more information on the pertussis vaccine?

Talk to your healthcare provider about the pertussis vaccine. Be sure to ask for a written record of your child’s vaccines.