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Complications Pertussis is feared for its complications, some of which are life threatening. Pneumonia - the most common cause of death in whooping cough. Intracranial hemorrhage. Encephalopathy. Ear infections. Poor appetitie, dehydration, and malnutrition. Pneumothorax. Nose bleed. Hernias. Rectal prolapse.
What is Infectiousness? Infectiousness of a disease refers to the possibility of people exposed to the disease to later develop that disease.  Dangerous diseases like hepatitis B and AIDS are poorly infectious, because they are only transmitted by blood contact, or by sexual activity.   On the other hand, viral colds and chicken pox are very infectious, because the person with the disease is releasing large number of viruses into the air around him by coughing and sneezing.  Other children can get the disease by simply being in the same classroom as him for a school day.   Secondary attack rate is the proportion of susceptible persons exposed to a particular disease who will get the disease.  For example, if there are a hundred children in a class, and forty have been vaccinated against pertussis, then the number of susceptibles if sixty. Though pertussis is highly infectious, the champion is probably measles, with a secondary attack rate approaching 100%.  Chicken pox in the home setting is almost as bad, but this falls to 60-70% in the school setting.

Whooping Cough
(Pertussis)

The scientific name is pertussis (intense cough), but it is also known as the hundred days' cough. A cough doesn't sound very dangerous, but whooping cough is an awful disease.  A child unfortunate enough to get it suffers terribly for several weeks.

Whooping cough is a common disease all over the world. In countries where most children receive the vaccine, the occurrence has reduced significantly. However, since vaccine induced immunity wanes with time, whooping cough is now becoming commoner in older children and teens. Earlier, the disease was most common in the 1-5 years age group.

The Disease

Whooping cough is caused by a bacterium, Bordetella pertussis. It is spread from a child with the disease to other children, through the air. Whooping cough usually occurs 7-10 days after contact with the disease.

The disease starts as a throat infection, with cold, cough, red eyes, and fever.  The cough gets worse and worse, and the diagnosis is usually made after a few days.

The cough occurs in prolonged bouts, during which the child is unable to breathe, and gets more and more anxious.  At the end of the bout, the struggling child draws in a deep breath with a loud whoop.  Not all children with pertussis have the characteristic whoop.  These bouts of cough are often followed by vomiting.  The cough is provoked by laughing, crying, and eating, making the child scared to do any of these.

The illness goes on for weeks, and most children lose weight, becoming malnourished.  The illness is associated with complications affecting several body organs, chiefly the brain and lungs.  Pneumonia, seizures, encephalopathy, bleeding into the brain, and bleeding in the eye are some of the complications.  It also allows old, quiescent tuberculosis to flare up.

Treatment

Though it is a bacterial disease, antibiotics are of small value in its treatment.  Once the disease has taken hold, antibiotics serve only to eradicate the infection and prevent spread.  The bouts of cough are not stopped by killing the bacteria.

Various cough syrups are tried in this disease, but give only partial relief.

Children who get pertussis develop immunity to the disease, but it is not long lived. They should be vaccinated with DTP or Tdap after some time. (See pertussis vaccines)

Immunity to whooping cough is not transmitted to the baby from the mother during pregnancy. Babies are thus unprotected at birth, and can get whooping cough at very young ages.

See also: Whooping Cough Vaccines

Last revision: July 01, 2008

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