Whooping Cough

Also called pertussis, whooping cough is a severe infection that occurs in the respiratory system from the Bordetella pertussis bacterium, also called B. pertussis. The condition received its name from the main characteristic of the infection which causes a quite severe spell of coughing that is concluded with loud whooping sounds as the person inhales. There was a time when the vaccine was not yet available, in which whooping cough claimed 5,000 to 10,000 people each year in the US. The development of the vaccine provided a treatment that was effective enough to severely decrease the death rate to less than 30, which has began to rise again in the most at risk patients.

Whooping Cough Becoming More Common

It is quite common and occurring more frequently in the most recent years. There are several cases that could occur with the symptoms lasting for about six weeks. There could be prolonged symptoms or short-term, but treatment must be sought out during the first onset of the infection in order for the main antibiotic used to be effective in treatment. If there is not prompt diagnosis or attention paid, the infection could run its entire course only causing minor coughing spells that over-the-counter medications are good for treating.
Whooping Cough Symptoms
Whooping cough arrives with several symptoms, progressing with the infection, with various groups at a higher risk than others for getting the infection. Thos with a compromised or developing immune system are typically at a greater chance of developing the condition, in which case there is a slight chance of fatality if the immune system is considerably low.

There is a highly effective preventative measure involving the DTaP vaccine that will protect against infection. As this infection is highly contagious, the necessary safeguards should be in place, especially in school age children that are currently attending school or daycare.

There are also various complications associated with whooping cough which include:

  • Pneumonia
  • Convulsions
  • Mental impairment
  • Brain damage
  • Apnea
  • Death

Whooping cough also presents other severe complications such as a permanent seizure disorder that will afflict the infected causing an epileptic like condition. Nose bleeds and ear infections can also be quite common with bleeding in the brain also possible. There is a lack of oxygen that occurs during a spell or from a complication which is the cause of any brain damage or mental retardation.

With children being so susceptible to the infection, it is important to contact a doctor if there are any symptoms that resemble pertussis. Emergency should be contacted if there are symptoms of:

  • Bluish tint to the skin
  • Apnea, or periods of stopping breathing
  • Seizures
  • High fever
  • Vomiting
  • Dehydration

These symptoms could be an indication that there is a serious complication that requires immediate attention.
Infants are the most susceptible and most in danger in the event of the pertussis infection, therefore will require much more care and monitoring than adolescents and adults.

Many times, whooping cough can carry out its course and leave no effects other than the coughing which can be relieved through the use of cough suppressants and various home remedies that provide a better and more suitable environment for treatment of whooping cough.

Symptoms

Once there has been exposure to the bacteria, it will take about a week for the initial symptoms to present. These symptoms are very similar to a simple cold that will continue to progress. Typically, 10-12 days after the initial symptoms arrive there will be severe coughing spells that will end in a whooping noise when seen in children. The sound is the result of attempting to inhale and is rare in adults and children under six months.

When coughing spells begin, they may be followed by severe persistent vomiting and even possibly unconsciousness.

When vomiting accompanies coughing, this is a big indicator that there is pertussis present. Infants can have choking spells as a common symptom of the condition. There are other symptoms as well including cold and flu like symptoms such as a runny nose, a fever up to 102 degree Fahrenheit, and even diarrhea. These accompany the initial symptoms and can lead to a wrong diagnosis of the flu or a minor cold.

Many times in adults, the condition remains as a dry and persistent cough that could cause:

  • Thick phlegm
  • Vomiting
  • Reddish or bluish face from lack of oxygen
  • Extreme fatigue

Adults and adolescents don’t typically experience the characteristic whoop and will likely just experience progressive coughing spells. In some cases, apnea or pneumonia could develop, especially in the case of a compromised immune system due to other diseases or infections.

Causes

The bacterium Bordetella pertussis, also known as Bordetella parapertussis or B. pertussis, is a highly contagious bacterium that causes the upper respiratory infection, pertussis, or whooping cough. This is a very serious disease that has been seen in infants to cause permanent disabilities, including brain damage, and can even be fatal.

The disease is interpersonal, spreading from person to person as the infected cough into the air and the uninfected inhale the bacteria. The bacteria travel through the air in tiny droplets, seeking a new host to infect. The infection generally lasts up to six weeks, but could be more or less depending on the patient.

Once the bacteria have entered the airways, it will begin to multiply, producing toxins that inhibit the respiratory tract’s ability to rid the germs that try to invade. Thick mucus begins to accumulate within the airways, causing the coughing spells and whooping sound as children try to inhale. As the airways are narrow, the whooping is the effect of a gasp of air seeking travel through a tube in the lungs that has been severely narrowed. In some cases, this gasping goes on to cause choking or even unconsciousness.

Risk Factors

Since infants’ immune systems are still in development, they are not able to fight off infections as well as adolescents and adults. Typically, those six months and younger are the most at risk as the resistance to the disease doesn’t generally build enough strength until at least three doses of the vaccination have been administered.

As whooping cough cases have been on the increase, it is now thought that the vaccination effects will begin to wear off through time, leaving teenagers and adults more susceptible in the case of an outbreak of pertussis, which seems to be occurring often and regularly.

Aged adults are also susceptible as their immune systems are not as strong as they used to be and in many times are compromised due to other health conditions. This increases the risk during an outbreak. Any individual who has not received the vaccination is also at great risk of contracting the infection.

Prevention Tips

The most common and effective, as well as the main and most necessary prevention against whooping cough are the pertussis vaccine, which is administered in the DTaP imunization given to children. The immunization consists of diphtheria, tetanus, and acellular pertussis vaccines that are given in five doses routinely in most children before the age of six. It is now recommended that for added protection after the vaccine has begun to wear off, children 11-18 receive the new Tdap vaccine. The recommended age is between 11 and 12, and the Tdap replaces the traditional Td booster.

With whooping cough being so contagious, it is best to avoid public areas during an outbreak if the vaccine hasn’t been administered. It has been shown that up to 80% of family members that haven’t been immunized will develop the infection when in the same house as an infected person.

If exposure to an exposed family member or other individual occurs, it is imperitive to seek a booster dose for children that haven’t received all five doses, and antibiotics in adults to avoid spread of the disease.

The vaccine does have side effects that include fever, irritability, and soreness around the injection site. There can be more severe side effects in more serious and rare cases including:

  • Persistent crying spells that last over three hours
  • High fever
  • Seizures, shock, or coma

Test and Diagnosis Considerations

Diagnosis typically begins with evaluation of the symptoms; however this can sometimes be difficult when the symptoms aren’t as obvious. There are some cases in infants when the symptoms can be from pneumonia, leading to more testing needed beyond symptoms checking. It is more often easier to diagnose in children from evaluation of the symptoms due to the whooping sound that accompanies the cough.

There is usually a sample taken of the mucus secreted from the nasal passage, which is sent to the lab and tested for the B. pertussis bacteria. This is a time-consuming test, which causes many treatments to already be started before results are shown.

There are blood tests used to diagnose the disease by showing an elevated white blood cell count indicating an infection is present. There are some patients that will show a complete blood count with high numbers of lymphocytes present. There may also be a throat culture taken in order to test at the lab for the bacteria.

In some cases a chest X-ray is used for the physician to look for any type of inflammation or fluid present in the lungs. This is a sign of pneumonia which could complicate the pertussis and create a higher fatality risk. This is a worst case scenario for children as they are often unable to fight off both conditions at once.

Treatment Options

The actual treatment taken to rid whooping cough is determinant upon the patient including information such as:

  • Health and medical history
  • Severity of the condition
  • Tolerance for medications, procedures, and various therapies
  • Expectations of the course of the infection
  • Patient preference

The most acute infections when caught in the later stages may only require minimal treatment, which typically consists of cough and respiratory relief.

The actual treatment of whooping cough greatly depends on the patient. Infants are more likely to receive hospital care for treatment as the disease is much more dangerous in that age. Intravenous fluids are also often used in children that aren’t able to keep fluids or foods down.
Whooping Cough Treatment
There will be a quarantine of the infected patient to prevent further spreading, with treatment for adolescents and adults being more appropriate within the home. There are several remedies used to treat, as well as medications in order to kill the bacteria and restore the respiratory tract.

Herbal and Home Remedies

There are many herbal and home remedies that provide relief of the symptoms and aid in the healing process. The most important tips given to alleviate the coughing spells and ease the treatment process for in-home treatment include:

  • Make sure to get plenty of rest.
  • Drink many fluids, including water, juice, and soup.
  • Eat small and frequent meals.
  • Vaporize the area.
  • Maintain clean air within the home: no smoking.

Garlic is often used as a very effective remedy for whooping cough. Syrup of garlic taken in five drop to one teaspoon doses two to three times per day can have a great effect in treating the infection. If there are more frequent and violent coughing spells and the condition is worse, the dose frequency can be increased. Almond oil is another effective treatment that can provide great relief of the symptoms. Honey, onion, and at least 10 to 12 glasses of water can wash the system of the toxins and replenish the respiratory tract. There are several other herbal and home remedies that can greatly benefit patients suffering from whooping cough.

Medical Treatment

It is encouraged to seek treatment for pertussis early to simplify the treatment process. Early treatment can be highly effective with antibiotics like erythromycin, which can alleviate the symptoms much quicker. Although most patients are diagnosed too late for effective treatment with antibiotics, they will still be given to prevent spreading of the disease.

Any infant 18 months or younger should be receiving constant supervision to monitor breathing. During continuous coughing and choking spells, infants have a tendency to stop breathing which could cause mental dysfunction or death. The more severe cases should be receiving 24/7 hospital care until the infection has been fully treated. Many times, there will be an oxygen tent used that provides high humidity and promotes the unblocking of mucus, allowing easier breathing.

Over the Counter Medicine

Once antibiotics are no longer useful as an effective treatment, a minor infection will commonly be treated with cough relief using over-the-counter cough medicine. The infection will be monitored either from home until it has dissipated and there are no more symptoms.

Erythromycin is typically the main drug used for treatment of whooping cough. If the patient seeks treatment before the coughing spells have begun, Erythromycin is effective at preventing the progression to the paroxysmal stage, which is when the coughing begins. If the coughing spells begin, it is necessary to treat the symptoms, but no medications can target the bacteria.

Surgery

Surgery is not a typical treatment for pertussis as it is an infection and cannot be treated with any form of surgery. However, there are cases when whooping cough creates a larger underlying condition that may require some sort of surgery. This could include the development of a hernia or other intestinal or organ issues. The severe coughing spells can create a force within the body that can damage some organs and specific areas.

Whooping cough is a quite common disease associated with the B. pertussis bacterium that is spread very easily. There are many patients each year treated for whooping cough and many times the infection remains minimal. There are some cases, however such as in infants where more serious attention must be given to the disease as their immune systems are not properly developed or as strong as others. Proper treatment of pertussis can vary depending on the age of the infection, age of the patient, and the severity.

Special Treatment Options

While most cases can be solved with rest and nourishment, there are some cases that can provide such restraint on the respiratory system that death can occur. There are always other conditions that can affect the patient and cause more severe and life-threatening issues, such as pneumonia. In the case of pneumonia, proper treatment should be sought out and there should be isolation of the infected person to ensure that spreading of the infection does not occur.

Children may be required to remain in the hospital for the duration of the infection to ensure that there are no further and more permanent complications associated with the disease.

Avoidance

To avoid getting the B. pertussis infection, it is necessary to avoid unsanitary contact with those who may be infected, as well as ensure that all children immunizations are administered to ensure protection. Children can be much more susceptible to the more serious risks and complications associated with the disease, which causes more urgency to ensure that all immunizations and boosters are received per schedule.


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