Pertussis, Child

Pertussis (whooping cough) is an infection of the respiratory tract. It causes severe and sudden attacks of coughing. Coughing attacks may occur frequently and can last about 2 minutes. Your child may have these attacks for 2 weeks or more. Mild coughing may continue for several months from the remaining soreness and swelling (inflammation) in the lungs even though the infection is no longer present. Pertussis is very contagious and usually affects infants, children, and adolescents. It is less common in adults.

CAUSES

Pertussis is caused by bacteria. It spreads easily to others by the droplets sprayed in the air from coughs and sneezes.

SYMPTOMS

The initial symptoms of pertussis are similar to the common cold. Your child may have a runny nose, sneezing, loss of appetite, a mild cough, and a low grade fever. These symptoms often last 2 to 7 days.

During the later stage of the illness, the severe and sudden coughing attacks develop. This stage may last 1 to 8 weeks. Coughing is often provoked by activity in older children. In infants, it may occur during feeding. After a severe cough, a child older than 6 months may gasp or make "whooping" sounds to get air. Newborns and young infants do not have the strength to develop this "whooping" sound and may instead have periods where they cannot breathe.

DIAGNOSIS

Your child's caregiver may recommend blood tests or mucus swabs of the nose and throat to help confirm the diagnosis. Your child may also need a chest X-ray.

TREATMENT

Antibiotic medicines may be prescribed for the infection. In confirmed cases of pertussis, the caregiver may prescribe antibiotics for everyone living in the same household as the sick child. The caregiver may recommend immunizations for people in the household at risk of developing pertussis.

HOME CARE INSTRUCTIONS

  • Have your child take his or her antibiotics as directed. Have your child finish them even if he or she starts to feel better.

  • For the first 5 days of treatment, keep your child away from others who:

  • Have not had their full course of pertussis immunizations.

  • Have not had their recent booster shot.

  • Are pregnant.

  • Have your child wash his or her hands often. Parents also need to wash their hands often to avoid spreading the infection.

  • Avoid exposing your child to substances that may irritate the respiratory tract such as smoke, aerosols, or fumes. These things may worsen your child's coughing.

  • Do not bring your child to school or daycare until he or she has been treated with antibiotics for 5 days. Inform your child's school or daycare that your child was diagnosed with pertussis.

  • Do not give cough medicine unless prescribed by the caregiver. Coughing is a protective mechanism which helps keep sputum and secretions from clogging breathing passages.

  • Use a cool mist humidifier at home to increase air moisture. This will soothe your child's cough and help loosen sputum. Do not use hot steam.

  • If your child is having a coughing spell:

  • Raise the head of his or her mattress to help clear sputum more easily and improve breathing.

  • Sit your child upright.

  • Have your child rest as much as possible. Normal activity may gradually be resumed.

  • Have your child drink enough fluids to keep his or her urine clear or pale yellow.

  • Have your child eat small meals often if he or she is vomiting because of coughing attacks.

  • Monitor your child's condition carefully until there is improvement. This infection can get worse after your hospital or office visit.

SEEK MEDICAL CARE IF:

  • Your child has persistent vomiting.

  • Your child is not able to eat or drink fluids.

  • Your child is urinating less frequently or has dry lips or sunken eyes (dehydrated).

  • Your child has repetitive coughing that gets worse.

  • Your child does not seem to be improving.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your child's lips or skin turn blue during a coughing spell.

  • Your child has trouble breathing or has periods when breathing slows or stops.

  • Your child is restless or cannot sleep.

  • Your child is acting listless or is sleeping too much.

  • Your child is not acting normally.

  • Your child who is younger than 3 months has a fever.

  • Your child who is older than 3 months has a fever and persistent symptoms. 

  • Your child who is older than 3 months has a fever and symptoms suddenly get worse.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your child's condition.

  • Will get help right away if your child is not doing well or gets worse.