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Whooping Cough: Diagnosis, Vaccination, and Treatment

Whooping cough is a highly contagious bacterial infection. It is caused by the bacterium Bordetella pertussis, which infects the lining of the airways such as the trachea and bronchi.
Although it primarily affects small babies, teenagers and adults can also get this infection. Occasionally, the infection can be contracted by vaccinated individuals. Also known as pertussis, whooping cough is a reportable disease in the USA.
whooping cough
According to an estimate by the World Health Organization (WHO) in 2008, global vaccination against whooping cough prevented almost 687,000 individuals from dying.[1]
Keeping in mind the effectiveness of the vaccine, WHO recommends the administration of the first dose to infants at around 6 weeks of age, with subsequent booster doses 4-8 weeks apart, at age 10 -14 weeks and then at 14-18 weeks.
Pertussis is not a common problem in industrial countries, albeit outbreaks happen from time to time. In countries where people are proactive about immunization, the risk of whooping cough is considerably low.
Note: Vaccines can curtail the risk of pertussis to a large extent. However, once you have contracted the disease, you must be attended to by a physician. Whooping cough, being a contagious disease, can be transmitted to other family members, exposing them to a huge risk of getting infected, which calls for treatment depending upon the situation.
Contents

Causes of Whooping Cough

Whooping cough is caused by an infection of the pertussis bacterium. The bacteria adhere to the cilia lining the respiratory airways, causing swelling in the upper respiratory tract. This infection is spread through droplets from an infected individual.
The incubation period, or the time between the infection and the first appearance of symptoms, is between 6 and 20 days.[2]
The infection may be spread through:
  • Sharing the same breathing space with an infected individual
  • Inhaling the airborne droplets when the affected individual coughs or sneezes
  • Contact with a household item that might have been in close vicinity of the infected individual
  • An infected family member
  • Saliva
A person is likely to remain infectious for almost 21 days of the cough or 5 days after they have had the 10-day prescribed antibiotic course.

Signs and Symptoms of Whooping Cough

Although infected with the pertussis bacteria, it may take about 6-20 days for the symptoms to appear in the individual. As whooping cough tends to mimic the common cold, it is necessary to identify it as a distinct infection by staying aware of its symptoms that may progress into vigorous forms.
These symptoms include:
  • Coughing in fits that may last for a few minutes and worsens during the night
  • A coughing bout accompanied with vomiting
  • Vigorous coughing that may strain your eyes and cause redness and even slight bleeding at times
  • Cyanosis in infants, in which their skin may turn blue when they experience troubled breathing
  • Troubled breathing, causing apnea
  • Low-grade fever
Besides these classic symptoms of pertussis, the affected individual may experience fatigue, dehydration, and poor appetite.

Diagnosing Whooping Cough

Your GP will conduct a physical examination and evaluate your symptoms. Your doctor is likely to recommend the following tests to ascertain the cause behind the symptoms:[3]
  • Chest X-ray to determine any respiratory infection, fluid buildup, or inflammation.
  • Blood tests to get an estimate of your white blood cell count. In general, a high white blood cell count is indicative of an infection or inflammation.
    In cases where the diagnosis becomes difficult, a mucus sample test may be prescribed to check for the presence of the pertussis bacteria in your nasal secretions.

Medical Treatment for Whooping Cough

The treatment for whooping cough depends on the duration of the infection and the age of the infected individual.
  • Children below 6 months of age with severe symptoms require hospital admission to get treated.
  • Individuals diagnosed in the first 3 weeks of the infection may be prescribed antibiotics and instructed to stay at home and isolate themselves to prevent the spread of infection.
  • Individuals who have been experiencing the symptoms of whooping cough for more than 3 weeks are, usually, not prescribed any medication as the bacteria may no longer reside in the system. The symptoms are manifested as a result of the harm already inflicted on the respiratory passages and tracts.
All household members in the close vicinity of the patient must be administered erythromycin as a post-exposure prophylaxis treatment to avoid getting infected in the near future. This is performed within 21 days of the onset of the hallmark cough in the patient.
Note:
  • It is very important to isolate the patient. This is to avoid the transmission of the infection to other people. Isolation is necessary at least until the patient has undergone 5 days of the antibiotic course. People sharing the same breathing space with the patient must cover their face with a mask when in the near vicinity of the sick individual.
  • Also, it is recommended that the family members of the patient get post-exposure prophylaxis to prevent the spread of bacteria any further in the vicinity.
  • If you notice any signs of breathing difficulties and excessive vomiting in your infected child, seek medical help immediately.

Instructions to Aid in the Treatment of Whooping Cough

It is advised by the doctors to make sure the patient:
  • Gets adequate rest to speed up recovery.
  • Drinks plenty of fluids to avoid getting dehydrated.
  • Ensures that the phlegm in the nasal and throat passages is regularly removed with ease.
  • Is given medicines to reduce the symptoms of fever and pain.
  • Is strictly isolated to avoid the spread of infection until the end of the severe whooping phase. Also, patients on an antibiotic course must be isolated until about 5 days after the start of the course.

Complementary Tips for Treating Whooping Cough

Along with the standard medical treatment prescribed by your doctor, you can try the following adjunctive remedies.

1. Take Enough Rest

Rest is necessary to boost the immune system. Avoid doing any physical exercise that can strain your body. Take adequate rest throughout the day to promote recovery.

2. Stay Hydrated

Drinking ample amount of water can keep you hydrated. It also helps moisten the airways and dislodge the mucus and reduce its thickness.
As being down with an illness can reduce your hunger and appetite, drinking fluids can come to your rescue. Also, combining your water with nutritive elements can help provide essential vitamins and minerals required to fight the infection.
  • It is advised to drink plenty of fluids in the form of water, smoothies, coconut water, soups, watery fruits, broths, and fruit and vegetable juices to steer clear of dehydration.
Avoid dairy products such as milk and ice cream these can thicken your mucus and aggravate your situation.
If you experience the symptoms of dehydration, consult your doctor immediately. The symptoms of dehydration include a dry mouth, perpetual thirst, headache, dizziness, muscle weakness, and decreased urination.

Foods That May Help

Your body needs nutrition to help counter a microbial invasion and repair the induced damage. It is necessary to supplement a wholesome diet with some foods that can nourish your sick body.
1. Ginger contains antibacterial and immune-boosting properties that may hasten the process of recovery.[5]
  • You can take a ginger and honey concoction in whooping cough. Mix 1 tablespoon each of freshly extracted ginger juice and raw honey. Take this mixture twice daily for a few days.
2. Vitamin C can help reduce the coughing fits of whooping cough as backed by studies dating back to a century.[6]
  • In your diet, include vitamin C-rich citrus fruits such as lemon to soothe your damaged respiratory tracts. Alternatively, you may consult your doctor for supplements.
3. Oregano is another effective herbal remedy for respiratory infections.[4]
  • You can inhale the vapors of oregano oil. Boil a pan of water and add 5-6 drops of pure oregano oil to it. Cover your head with a towel and inhale the steam. Use this remedy two to three times a day for a few days to ease coughing.
Note: These remedies are adjuncts. Once you have contracted the disease, you must be attended to by a physician and follow the prescribed course and instructions.

Stages of Whooping Cough

Whooping cough presents itself in three stages – as the symptoms first appear towards the point of recovery.

1. Catarrhal

The pertussis symptoms are very similar to those of the common cold in the initial stage. These symptoms begin 5-10 days after you have been exposed to the infection and last for about 3 weeks, which is the end of the incubation period.

2. Paroxysmal

This is the most severe stage of the infection, which lasts from 1 week to for as long as 10 weeks. It is accompanied by multiple harsh bouts of cough, occurring after every 24 hours. In a bid to remove the trapped mucus from the lungs, the individual coughs vigorously and violently. The cough may end with a “whooping sound” as the air travels back into the lungs after the coughing. There may be an incidence of vomiting during one of the coughing fits.

3. Convalescent

This stage lasts for 1-3 weeks where the severity of the cough has reduced considerably, and the body is trying to recover from the infection.

Vaccination Against Pertussis

The best way to prevent contracting whooping cough is pertussis vaccination. The vaccination begins during infancy, and adults can also get it.
The vaccine called Tdap (tetanus, diphtheria, acellular pertussis) can be administered in adults, infants, and adolescents to prevent whooping cough.[7]
It is recommended by the Centers for Disease Control and Prevention (CDC) to get a single dose of Tdap instead of the booster dose of Td against diphtheria. The formulation of the vaccine may differ for young children, known as DTaP.

Complications related to Whooping Cough

You can easily tread on the road to recovery by taking proper care. However, it is necessary to visit the doctor if you observe any symptoms of whooping cough. Medical intervention is necessary to analyze your condition.
Also, getting yourself medically reviewed can abridge your chances of falling prey to complications. There are chances that whooping cough may take an ugly turn in older adults and young infants who have not had their pertussis vaccine yet.
The complications include:[2]
• Reduced supply of oxygen to the blood as a result of the coughing bouts
• Pneumonia
• Eye infections
• Sleep apnea, troubled breathing while sleeping
• Insomnia, inability to sleep
• A decrease in body weight

When to See a Doctor

Seek immediate medical attention if you observe the classic symptoms of whooping cough. Besides that, the major red flags that call for a healthcare professional’s review include:
  • Cough lasting for more than 3 weeks
  • A cough that is worsening or tends to get severe with time
  • Difficulty breathing including breathlessness, choking, periods of breathing cessation, a bluish tinge on the skin, and shallow breathing.
  • Developing signs of pneumonia or experience seizures
Note: Seek prompt medical attention at the slightest appearance or suspicion of the disease.

Additional Tips When Suffering from Whooping Cough

  • Quit smoking.
  • Tie a small piece of camphor in a handkerchief and sniff it from time to time.
  • Avoid exposure to cold and moisture as they can worsen the condition.
  • Keep your home free of irritants such as fire or tobacco smoke that can trigger coughing.
  • Cover your mouth while coughing and wash your hands often.
  • When going out, wear a mask.
  • Avoid foods that can cause allergy in your upper respiratory tracts, including dairy, sugar, gluten, and soy. Also, do not eat foods that are dry and crumbly; these can induce a coughing spasm.
  • Stick to eating small meals that are easy to digest to prevent the expulsion of food during a coughing fit.
  • Installing a humidifier can help soothe your airways and keep them moist.
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