Pertussis/Whooping Cough

By Dr. Brown

There has been an increased activity of reports in Chicago of Pertussis. 

Clinical Manifestations:  Pertussis begins with mild cold like symptoms and progresses into cough and paroxysms of cough often with the characteristic inspiratory whoop and commonly followed by vomiting.
 Fever is minimal or absent. 
Symptoms go away over weeks to months.
Disease in infants younger than six months may present with apnea (stoppage of breathing) and the whoop is many times absent.
  The classic duration is six to ten weeks. In fact, the old fashioned name was the "HUNDRED DAY COUGH."

Check out the YouTube Video below and you can hear the classic inspiratory "whoop". Thanks to whoever uploaded this video.

Complications: are mostly in the younger ages, particularly those less than six months of age.



Etiology: 
The bacteria called Bordetella pertussis and Bordetella parapertussis are the causative agents.
 Humans are the only known host of this illness.


Incubation Period: is 6-21 days, usually 7-10 days.


Diagnostic Tests: include a culture on culture material that we do not carry in the office. This must be done in the Hospital Lab. A simple blood test known as a CBC can be done in the office which may show characteristic patterns but this is not diagnostic for Pertussis.


TREATMENT
Patients who have not received their full course of DTaP shots should complete them now if possible. Usually they are given at 2 months, 4 months, 6 months, 18 months, and 4 years of age - a total of 5 shots.  

The Tdap vaccine is for ages 7 and older and usually given as a booster in middle school.  
Treatment of ill patients includes a 14 day course of Erythromycin or Clarithromycin or Azithromycin. 

EXPOSED PATIENTS 
Whether or not to treat exposed patients depends on the degree of contact to the sick patient. These are divided into two general categories: CLOSE CONTACTS like family members, boyfriend/girlfriend, etc.,  and CASUAL CONTACTS at school, while on sports team, attendance at various functions, etc. Only known close contacts are treated, and they receive a 14 day course of antibiotics also. 
Patients who are diagnosed and treated are not allowed to be in school for 5 days after treatment begins so as to not infect others. Because of HIPAA privacy rules the health department can not reveal the names of "index" cases. 


WHEN TO CALL:

Call our office to verify immunizations status if you are unsure. Remember, schools are looking out for those children who are not up to date with their shots. 
Call if your child(ren) have had a close exposure as outlined above. 
Call if there is a casual contact AND a cough.