Whooping, << HOO pihng, >> cough, also called pertussis, is a serious, highly contagious disease of the respiratory system. The name whooping cough comes from the high-pitched, whooping noise victims make when they try to catch their breath after severe coughing attacks. Whooping cough occurs worldwide, mainly among infants and young children. It is caused by a bacterium called Bordetella pertussis.
From the 1950’s through the 1970’s, the number of cases and the severity of whooping cough declined sharply in the United States and many other countries. These changes resulted from the widespread use of pertussis vaccine and from improvements in the standard of living and in health care. In the early and mid-1980’s, however, the percentage of young children in the United States who received the vaccine declined. As a result, the number of cases of whooping cough in the United States more than tripled from 1980 to 1986 and then continued to increase. Another sharp increase occurred after 2002 as protection from childhood vaccinations faded among many adolescents and adults.
Symptoms
of whooping cough progress through three stages. These stages, in order of development, are (1) the catarrhal stage, (2) the paroxysmal stage, and (3) the convalescent stage.
During the catarrhal stage, which lasts from one to two weeks, symptoms resemble those of the common cold. Victims have trouble breathing, due to inflammation and an increase of mucus in the nose and throat. They cough and have a fever. At this stage, the disease is highly contagious. It spreads through the spray of bacteria-filled droplets from the victim’s nose and mouth. The catarrhal stage generally lasts from one to two weeks.
The paroxysmal stage, during which the “whoop” occurs, is the most serious phase of the disease. It generally lasts from two to three weeks. In this stage, severe coughing paroxysms (attacks) occur first at night, then later during both the day and night. Victims often spit up thick globs of mucus following these coughing spells. Infants often swallow the mucus and then vomit, which can cause dehydration and weight loss. The attacks can lead to inadequate oxygen circulation, which can cause convulsions. Other complications may include pneumonia or collapse of the lungs. Victims of whooping cough, especially infants under 6 months of age, may die during the paroxysmal stage.
During the convalescent stage, coughing, spitting up mucus, and vomiting begin to lessen. Victims show general improvement and finally return to a normal state of health. Full recovery may take weeks or months.
Treatment and prevention.
Physicians use the antibiotic erythromycin to treat whooping cough. If given in the catarrhal stage, this drug can halt the illness or lessen its severity. After the paroxysmal stage begins, treatment centers on helping the patient breathe freely and on limiting the number of severe coughing attacks.
Immunization of infants and young children with pertussis vaccine protects them from whooping cough. For a recommended schedule of whooping cough immunizations, see Immunization (table: Recommended immunization for children in the United States) . Physicians prescribe erythromycin to help prevent the development of whooping cough in unvaccinated people who have been exposed to the disease.
