Friday, April 20, 2018

Whooping cough

Whooping cough (pertussis) is a highly contagious respiratory tract infection. In many people, it's marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like "whoop."

Before the vaccine was developed, whooping cough was considered a childhood disease. Now whooping cough primarily affects children too young to have completed the full course of vaccinations and teenagers and adults whose immunity has faded.

Deaths associated with whooping cough are rare but most commonly occur in infants. That's why it's so important for pregnant women — and other people who will have close contact with an infant — to be vaccinated against whooping cough.

Symptoms
Once you become infected with whooping cough, it takes about seven to 10 days for signs and symptoms to appear, though it can sometimes take longer. They're usually mild at first and resemble those of a common cold:

Runny nose
Nasal congestion
Red, watery eyes
Fever
Cough
After a week or two, signs and symptoms worsen. Thick mucus accumulates inside your airways, causing uncontrollable coughing. Severe and prolonged coughing attacks may:

Provoke vomiting
Result in a red or blue face
Cause extreme fatigue
End with a high-pitched "whoop" sound during the next breath of air
However, many people don't develop the characteristic whoop. Sometimes, a persistent hacking cough is the only sign that an adolescent or adult has whooping cough.

Infants may not cough at all. Instead, they may struggle to breathe, or they may even temporarily stop breathing.

When to see a doctor
Call your doctor if prolonged coughing spells cause you or your child to:

Vomit
Turn red or blue
Seem to be struggling to breathe or have noticeable pauses in breathing
Inhale with a whooping sound

Causes
Whooping cough is caused by a type of bacteria called Bordetella pertussis. When an infected person coughs or sneezes, tiny germ-laden droplets are sprayed into the air and breathed into the lungs of anyone who happens to be nearby.

Risk factors
The whooping cough vaccine you receive as a child eventually wears off. This leaves most teenagers and adults susceptible to the infection during an outbreak — and there continue to be regular outbreaks.

Infants who are younger than age 12 months who are unvaccinated or haven't received the full set of recommended vaccines have the highest risk for severe complications and death.

Complications
Teens and adults often recover from whooping cough with no problems. When complications occur, they tend to be side effects of the strenuous coughing, such as:

Bruised or cracked ribs
Abdominal hernias
Broken blood vessels in the skin or the whites of your eyes
Infants
In infants — especially those under 6 months of age — complications from whooping cough are more severe and may include:

Pneumonia
Slowed or stopped breathing
Dehydration or weight loss due to feeding difficulties
Seizures
Brain damage
Because infants and toddlers are at greatest risk of complications from whooping cough, they're more likely to need treatment in a hospital. Complications can be life-threatening for infants younger than 6 months old.

Prevention
The best way to prevent whooping cough is with the pertussis vaccine, which doctors often give in combination with vaccines against two other serious diseases — diphtheria and tetanus. Doctors recommend beginning vaccination during infancy.

The vaccine consists of a series of five injections, typically given to children at these ages:

2 months
4 months
6 months
15 to 18 months
4 to 6 years
Vaccine side effects
Side effects of the vaccine are usually mild and may include a fever, crankiness, headache, fatigue or soreness at the site of the injection.

Booster shots
Adolescents. Because immunity from the pertussis vaccine tends to wane by age 11, doctors recommend a booster shot at that age to protect against whooping cough (pertussis), diphtheria and tetanus.
Adults. Some varieties of the every-10-year tetanus and diphtheria vaccine also include protection against whooping cough (pertussis). This vaccine will also reduce the risk of your transmitting whooping cough to infants.
Pregnant women. Health experts now recommend that pregnant women receive the pertussis vaccine between 27 and 36 weeks of gestation. This may also give some protection to the infant during the first few months of life.

Preventive medications

If you've been exposed to someone who has whooping cough, your doctor may recommend antibiotics to protect against infection if you:

Are a health care provider
Are pregnant
Are younger than age 12 months
Have a health condition that could put you at risk of severe illness or complications, such as a weakened immune system or asthma
Live with someone who has whooping cough
Live with someone who is at high risk of developing severe illness or complications from a whooping cough infection

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