From the Guidelines
Whooping cough, or pertussis, is a highly contagious bacterial respiratory infection that requires prompt medical attention with antibiotic treatment, typically azithromycin for 5 days, to reduce morbidity and mortality. If you suspect whooping cough, see a doctor immediately for antibiotic treatment, or alternatives like clarithromycin or trimethoprim-sulfamethoxazole for those with allergies, as treatment works best when started early, ideally within 3 weeks of symptom onset 1. While recovering, get plenty of rest, stay hydrated, use a humidifier to ease breathing, and avoid irritants like smoke. The infection is caused by Bordetella pertussis bacteria and characterized by severe coughing fits followed by a distinctive "whoop" sound when inhaling. Some key points to consider in the management of whooping cough include:
- Antibiotic treatment should be started as soon as possible, ideally within the first 3 weeks of symptom onset, to reduce the severity of symptoms and prevent transmission to others 1.
- Azithromycin is a preferred treatment option due to its effectiveness and better side-effect profile compared to erythromycin 1.
- Prevention through vaccination is crucial, with DTaP recommended for children and Tdap for adolescents and adults, especially pregnant women and those in close contact with infants 1.
- Whooping cough can be particularly dangerous for babies under 6 months, who may require hospitalization if infected 1. It is essential to note that:
- Long-acting β-agonists, antihistamines, corticosteroids, and pertussis Ig are not recommended for patients with whooping cough as there is no evidence of their benefit 1.
- Vaccination with the stronger formulation of TDap vaccine should be administered according to CDC guidelines for all adults up to the age of 65 1.
From the Research
Definition and Treatment of Whooping Cough
- Whooping cough, also known as pertussis, is a highly contagious disease that can be severe and life-threatening, especially in infants 2, 3.
- The disease is caused by the bacterium Bordetella pertussis and can be treated with antibiotics, which are effective in eliminating the bacterium from the body 2, 3.
- Short-term antibiotics, such as azithromycin for three to five days or clarithromycin for seven days, are as effective as long-term antibiotics, such as erythromycin for 10 to 14 days, in eradicating B. pertussis from the nasopharynx 2, 3.
Vaccination and Prevention
- The diphtheria-tetanus-pertussis (DTP) vaccine can prevent diphtheria, tetanus, and pertussis, and is recommended for children at 2,4,6,15-18 months, and 4-6 years of age 4, 5.
- Mixing of DTP vaccines from different brands is common, with 4.7% of children receiving a mixed series for the first three doses, increasing to 39.0% for all five doses 4.
- Vaccination programs should be updated for household contacts of individuals with whooping cough, and antibiotic prophylaxis should be given to high-risk individuals, such as those who are not fully immunized 6.
Diagnosis and Management
- Diagnosis of whooping cough can be confirmed through culture, PCR, or serology, and is typically characterized by an unexplained prolonged cough with nocturnal exacerbation 6.
- Infants under three months with whooping cough should be admitted to hospital and isolated, and household contacts should be given prophylactic antibiotic treatment 6.
- In cases of grouped cases, public health system doctors should be involved in the investigation and classification of cases, and preventive measures should be applied to close contacts who are not fully immunized 6.