Pertussis.html

About Your Diagnosis
Pertussis or “whooping cough” is a highly contagious bacterial disease usually occurring in children younger than 4 years. The causative agent is Bordetella pertussis, which is usually transmitted by aerosol spread and inhalation. The incubation period is approximately 7–14 days, during which time the organism invades the upper and lower airways, resulting in increased mucus secretion.
Cultures of the nasopharynx, obtained by using a sterile cotton swab, as well as specific antibody testing are often diagnostic. Certain viral infections and
tuberculosis can also mimic the pertussis syndrome.

Living With Your Diagnosis
There are usually three stages to the disease. The first stage has a relatively gradual onset and is associated with sneezing, runny nose, and fatigue, in addition to a hacking nighttime cough. After about 10–14 days, the cough becomes more frequent and more intense, followed by the whoop (a hurried, deep inspiration). During this second stage, lots of thick secretions may be produced, sometimes with vomiting and gagging. The recovery stage usually begins within 4 weeks, although recurrence of the coughing episodes may occur for several months in association with possible upper respiratory tract infections.

Treatment
The best treatment is prevention by active immunization. Starting oral antibiotic therapy during the incubation period, and continuing for 10–14 days may abort the infection. Isolation of affected individuals for at least 4 weeks or until symptoms have subsided is advised, although the use of antibiotic therapy may be helpful in diminishing infectivity to others. Hospitalization is recommended for seriously ill infants, in addition to use of small frequent meals and fluid replacement. Supplemental oxygen may be required, as well as close monitoring and aspiration precautions. Pertussis may be very serious in children younger than 2 years, with a mortality rate of approximately 1% to 2% in children younger than 1 year. Most frequent complications include bronchopneumonia, collapsed lung, convulsions, and hemorrhage. Ear infections are also common and may require further antibiotic therapy.

The DOs
Pertussis immunization has reduced the problems of this illness. Respiratory isolation and completion of antibiotic therapy as advised by your doctor is important. Careful hand washing and close attention to nutritional needs, especially fluid intake when vomiting occurs, are very important.

The DON’Ts
Don’t stop medications unless advised by your doctor, even if the child is feeling well. Bed rest is not completely necessary for older children with mild disease. Do not force children to eat large quantities of food because this may only aggravate gagging and vomiting during coughing spells. Suction of excess mucus from the throat may be necessary. A darkened, quiet room with little disturbance may also help reduce the frequency and severity of the coughing or choking spells.

When to Call Your Doctor
Contact your doctor if your child comes into contact with another child who has had a recent diagnosis of whooping cough. For a child with pertussis, the caregiver should be prepared to closely monitor the child, as well as to follow respiratory isolation procedures. Pertussis is a serious illness and may be fatal, especially in young children.