WHOOPING COUGH
DEFINITION
Whooping cough is a highly contagious disease caused by bacteria. The disease is also known as pertussis (pronounced pur-TUSS-iss). The most prominent symptom of whooping cough is a distinctive, uncontrollable cough, followed by a sharp, high-pitched intake of air. This intake of air causes the characteristic "whoop" for which the disease is named.
DESCRIPTION
Whooping cough is caused by a bacterium called Bortadella pertussis. When inhaled, the bacterium attaches itself to cilia in the respiratory (breathing) tract. Cilia are tiny, hair-like projections on cells that beat back and forth constantly. This motion helps clear the respiratory system of bacteria, viruses, dead cells, and other material.
Bortadella pertussis interferes with the motion of cilia. The materials normally cleared away by cilia become lodged in the respiratory system and the cough that results is the body's way of attempting to rid the respiratory system of these materials.
Whooping cough exists everywhere in the world and can lead to a variety of diseases and complications, including death. Whooping cough can occur in people of all ages, but it is most serious when it strikes children under the age of two.
A person who has whooping cough at a young age becomes partially immune to the disease, which means that the person is less likely to have the same disease later in life.
CAUSES
Whooping cough is caused by bacteria entering a person's body. The bacteria are usually carried in droplets of water coughed into the air by an infected person. The incubation period for the disease is seven to fourteen days. The incubation period for a disease is the time between the start of the infection and the first appearance of symptoms. During this period, bacteria are multiplying in the respiratory tract.
SYMPTOMS
The second stage of whooping cough lasts about ten to fourteen days. During this period, the disease is often mistaken for a bad cold (see common cold entry). The patient has teary eyes, sneezing, fatigue, poor appetite, and a runny nose.
The third stage of the disease lasts two to four weeks. It is during this stage that the characteristic whooping cough begins. The cough is thought to be caused by inflammation of the respiratory system. The breathing tubes become narrowed, making it difficult for the person to get enough air to breathe normally. The effort to get air causes the gasping sound that accompanies the cough.
Whooping Cough: Words to Know
- Bortadella pertussis:
- The bacterium that causes whooping cough.
- Cilia:
- Tiny, hair-like projections on many cells that help keep the respiratory system clear of foreign materials.
- Immunization:
- The process of injecting a material into a person's body that protects that person from catching a particular infectious disease later in life.
- Throat culture:
- A sample of tissue taken from a person's throat for analysis. The culture is often taken by swiping a cotton swab across the back of the throat.
Severe exhaustion often occurs during the third stage of the disease. Patients can work so hard to get enough oxygen into their lungs that they become very tired. In children with whooping cough, the skin may begin to turn blue. The blue color indicates that the child's body is not getting enough oxygen.
Serious complications may also develop during this stage. For example, children may experience brain damage. Brain damage can occur because the brain is not getting enough oxygen, which causes brain cells to die. Also, the violent shaking caused by coughing can cause physical damage to the brain. An inadequate supply of oxygen to the brain can also cause seizures.
Another complication of whooping cough is hernias (see hernia entry). Hernias are abnormal protrusions (pushing out) of the intestine through the abdominal wall. The force of the coughs can cause the pressure needed to produce a hernia.
As the patient becomes weaker, he or she may become more subject to other bacterial infections of the lung, such as pneumonia (see pneumonia entry).
The final stage of whooping cough is recovery. This stage can last up to four weeks. Over this time, coughing may gradually become less intense as the patient gets better.
DIAGNOSIS
Whooping cough can be difficult to diagnose. Heavy coughing is characteristic of many diseases. For example, a heavy cold, a case of influenza (the flu; see influenza entry), or bronchitis (see bronchitis entry) all have symptoms similar to those of whooping cough.
A clear diagnosis can be made, however, by taking a throat culture. To do a throat culture, a doctor or nurse wipes a cotton swab across the back of the patient's mouth. The material collected is then studied under a microscope to determine if pertussis bacteria are present.
TREATMENT
Patients can be treated during the early stage of whooping cough with an antibiotic. The antibiotic usually used is erythromycin (pronounced i-rithruh-MY-sin). This treatment has limited value, however. The cilia are damaged early in the disease and once they are damaged, no drug can repair them. The cilia eventually grow back and begin to function normally. Until that happens, however, the patient will simply have to endure the symptoms of the disease.
There are ways, however, to make the patient more comfortable during the later stages of the disease. For example, liquids are recommended to keep the patient from becoming dehydrated. Rest is also suggested in order to reduce the amount and the intensity of the coughing.
PROGNOSIS
The vast majority of people who have whooping cough recover without further damage. Less than 1 percent of whooping cough cases end in death. Children are most likely to develop complications that lead to death. Common complications include pneumonia and extreme weight loss.
PREVENTION
Whooping cough can be prevented efficiently by immunization. Immunization is the process of injecting a person with a vaccine that prevents an infectious disease from occurring. A vaccine is a substance that causes the body immune system to build up resistance to a particular disease. The immunization shot given for whooping cough (pertussis) also contains vaccines for two other diseases, diphtheria and tetanus (see tetanus entry). The vaccine is sometimes called the DPT vaccine for the three diseases it helps protects against.
Medical experts recommend vaccinating all children for these diseases at the age of two months. The children are then protected for life. At one time, there was some concern about possible side effects from the DPT vaccine. Research has shown, however, that the vaccine is safe. In areas where it has not been used, there have been widespread epidemics of one or more of these diseases.
FOR MORE INFORMATION
Books
Stoffman, Phyllis. The Family Guide to Preventing and Treating 100 Infectious Diseases. New York: John Wiley & Sons, 1995.