What is pertussis?
Pertussis, more commonly known as whooping cough, is caused by a bacterium
(germ), Bordetella pertussis, that lives in the mouth, nose and throat.
The germ is highly contagious and is easily spread from person-to-person.
How is pertussis spread?
The bacteria are shed in discharges from the nose and throat and spread
to others through coughing and sneezing. An infected person is contagious
from just before onset of symptoms until up to three weeks after symptoms
start. Treatment with appropriate antibiotics shortens the contagious
period to about five days.
Who is susceptible to contracting pertussis?
Despite the effectiveness of vaccination, pertussis continues to occur
in the United States among all age groups. Anyone who has not had pertussis
previously or who has not received the pertussis vaccine can get the disease.
Immunity following disease or vaccination is not lifelong. Older children,
adolescents and adults can become susceptible to pertussis five-to 10-years
after their last dose of pertussis-containing vaccine. Older children
and adults can carry the germ and spread it even though their cold-like
symptoms may be so mild they might not seek medical care.
Since 2000, about a quarter of the cases reported have occurred in children
younger than 1 year of age and this group has the highest rates for complications
and death. Older children and adolescents have accounted for more than
half the reported cases, and adults 20 years of age and older comprise
the remaining 25 percent of reported cases.
What are the symptoms of pertussis?
Symptoms usually appear five-to 10-days after exposure, but can take as
long as 21 days. The first symptoms are similar to those of a common cold
- a runny nose, sneezing, low-grade fever and a mild, occasional cough.
The cough gradually becomes severe and, after one to two weeks, the patient
has spasmodic bursts of numerous, rapid coughs. The characteristic high-pitched
"whoop," which is more common in children, comes from breathing
in after a coughing episode. During such an attack, the patient may turn
blue, vomit and become exhausted. Between coughing attacks, the patient
usually appears normal.
Coughing attacks occur more frequently at night. The attacks increase
in frequency for a couple of weeks, remain at the same level for two-to
three-weeks, and then gradually decrease. Coughing may last as long as
100 days. Cough medicines usually do not help eliminate this cough. Recovery
is gradual, but coughing episodes can recur for months after the onset
Can there be complications?
Although most people recover, complications of pertussis can be severe.
It can be a critical illness in children younger than 1 year of age, especially
in premature babies or those with lung disease. Nationally, there were
27 deaths reported among infants with pertussis in 2004. Less serious
complications include ear infections, loss of appetite and dehydration.
Although infrequent, complications affecting the brain, such as convulsions
and inflammation, may occur, especially in infants, and can have long-term
effects or cause death.
How is pertussis treated?
Pertussis is usually treated with a multi-day course of appropriate antibiotics,
such as azythromycin, erythromycin or clarithromycin, or an acceptable
alternative. Some children may need to be hospitalized. People in close
contact with children or adults with pertussis usually need to be treated
with antibiotics and efforts should be taken to minimize an infant’s
exposure to children and adults with cough illnesses.
Can pertussis be prevented?
Every child should get pertussis vaccine at 2, 4, 6 and 15 months of age
and another dose at 4 to 6 years of age. This vaccine is given in the
same shot with diphtheria and tetanus vaccines. Immunization is required
for child care and school attendance.
New booster vaccines became available in 2005 that offer continued protection
against pertussis, diphtheria and tetanus for adolescents and adults.
These vaccines have been added to the recommended schedule of vaccinations
for adolescents. Adults with routine contact with infants less than 12
months of age should receive a booster dose.
Are there side effects to the vaccine?
Local reactions, such as redness, pain and swelling, are common. Occasionally,
a lump can be felt at the injection site for several weeks. Reactions
such as fever, drowsiness, fretfulness and loss of appetite occur frequently.
Most of these problems resolve by themselves. Less frequently, high fever,
persistent inconsolable crying lasting more than three hours, fainting
or an unresponsive collapsed-like state, and convulsions can occur. Very
rarely, severe nervous system problems have been reported.
Updated December 2006
Illinois Department of Public Health
535 West Jefferson Street
Springfield, Illinois 62761
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