Pertussis. Whooping cough. What you should know…

Pertussis.  Whooping cough.  What you should know…

Pertussis is also called whooping cough.  It continues to be a public health concern (with nearly 20 million infections worldwide yearly) despite there being an effective vaccine.  My husband got whooping cough years ago, we remember it well.

What are the symptoms of pertussis?  First, the patient has a runny nose, then coughs with a classic “whoop.”  A whoop is when you cough sooooo much that there is no more air in your lungs and you make a “whooping” sound while filling your lungs back up with air.  Then, the last stage of pertussis is a persistent cough. Overall, the uncontrolled coughing can last for MONTHS, even if you are treated with antibiotics. Antibiotics make you not contagious, it does not cure the cough. Additionally, studies have not shown any medications that decrease the pertussis-cough.

How to test for pertussis?  The diagnosis is made by a polymerase chain reaction test (PCR) using a nasopharyngeal swab with results coming back in 1-2 days. In the past we did cultures that took a week to result, but these are no longer done. 

How to avoid pertussis?  Get a Tdap vaccine, avoid sick people, and consider wearing a mask!  The Tdap vaccine is a combination tetanus AND pertussis vaccine. 

Who gets a Tdap vaccine?  Everyone should.  We give the vaccine to children (and it is required by most school districts to attend in-person school). The last scheduled dose is given to teens at age 11-12.  After age 12 a tetanus vaccine should be given every 10 years and ONE of the tetanus vaccines can be a TdaP (with pertussis) as an adult.  All pregnant women, regardless of the timing of their last Tdap, should receive a Tdap vaccine in their third trimester as this gives some immunity to the newborn.  More than 85% of pertussis deaths occur in infants too young to receive the pertussis vaccine.  Newborns get the pertussis vaccine at ages 2,4, and 6 months of age and are not thought to be immune to the infection until after their 6 month dose.  This is why it is important for those who have exposure to newborns (like grandparents) to get the Tdap vaccine if they have not had one as an adult.

How to treat pertussis?  We give antibiotics.  But, the antibiotics does not shorten the disease course or improve symptoms in the person infected.  Antibiotics DO prevent transmission of pertussis to others. Antibiotics should also be considered for those within 21 days of a known exposure to pertussis.  Azithromycin is the preferred antibiotic. 

I hope this helps…

About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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