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Whooping Cough
Definition

Whooping cough \u2014 known medically as pertussis \u2014 is a highly contagious
respiratory tract infection. Although it initially resembles an ordinary cold, whooping
cough may eventually turn more serious, particularly in infants. In the more advanced
stages, it's marked by a severe, hacking cough followed by a high-pitched intake of
breath that sounds like "whoop."

The incidence of whooping cough has been increasing, primarily among children too
young to have completed the full course of vaccinations and teenagers whose
immunity has faded.

With proper care, most teenagers and adults recover from whooping cough without
complications. Whooping cough is more serious in children, especially infants
younger than 6 months of age.

Symptoms
Early signs and symptoms

Once you become infected with the bacterium that causes whooping cough, it takes
about three to 12 days for signs and symptoms to appear. They're usually mild at first
and resemble those of a common cold, such as:

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A runny nose
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Nasal congestion
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Sneezing
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Red, watery eyes
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A mild fever
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Dry cough
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General feeling of being unwell and loss of appetite
Later stage signs and symptoms
After a week or two, signs and symptoms become worse and usually include:
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Severe coughing attacks that bring up thick phlegm
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Coughing attacks \u2014 up to 15 coughs in a row \u2014 that end with a high-pitched
"whoop" sound during the next breath of air
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In children, severe coughing that leads to vomiting or causes a red or blue face
from the effort
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Fatigue from the exertion of coughing
Coughing characteristics

In adults, signs and symptoms of whooping cough may resemble those of bronchitis, a
respiratory infection that causes a nagging cough. Babies and infants with whooping
cough may not whoop at all, or at least not as loudly as older children do. Some

children with whooping cough may experience choking spells and turn blue in the
face as they struggle to breathe after extended coughing.

Severe coughing can result in tiny red spots caused by ruptures in blood vessels at the skin's surface (petechiae) in the upper body, as well as small areas of bleeding in the whites of the eyes. You may even bruise or break a rib if your coughing episodes are severe. Coughing may be worse at night.

Causes

Whooping cough is a respiratory infection affecting mostly the windpipe (trachea)
and the tubes branching off from the windpipe (bronchi). It's caused by the Bordetella
pertussis bacterium, which is transmitted through droplets that are coughed or sneezed
into the air by someone who's already infected. Whooping cough is most contagious
early on, but the possibility of spreading the illness remains until the infection clears
completely.

Once inside your airways, the bacteria multiply and produce toxins that interfere with your respiratory tract's ability to sweep away germs. Thick mucus accumulates inside your airways, causing uncontrollable coughing.

The bacteria also cause inflammation that narrows breathing tubes in your lungs. This
narrowing leaves you gasping for air \u2014 sucking in air with a high-pitched "whoop"
\u2014 after a fit of coughing.

Risk factors

Some people think of whooping cough as having gone the way of polio \u2014 a
childhood disease eradicated thanks to a vaccination campaign. But whooping cough
hasn't been wiped out. In fact, the number of reported cases in the United States has
been increasing since a historic low of approximately 1,000 cases in 1976. In 2004,
more than 25,000 cases were reported, the largest number since the 1950s, according
to the American Academy of Pediatrics.

Whooping cough is thought to be on the rise for two reasons. The whooping cough
vaccine you receive as a child eventually wears off, leaving most teenagers and adults
susceptible to the infection during an outbreak \u2014 and there continue to be regular
outbreaks. In addition, children aren't fully immune to whooping cough until they've
received at least three shots, leaving those 6 months and younger at greatest risk of
getting the infection.

When to seek medical advice

Call your doctor immediately if you experience prolonged, severe coughing spells,
especially if these spells make you turn red or blue, are followed by vomiting or occur
together with a whooping sound when inhaling. Call your child's doctor if your child
experiences any of the same symptoms.

In addition, call your doctor if you or your child has been exposed to someone with
whooping cough, even if you've been vaccinated. You or your child may need
treatment with antibiotics or perhaps a booster of whooping cough vaccine to prevent
infection.

Tests and diagnosis

Diagnosing whooping cough in its early stages can be difficult. That's because the
signs and symptoms resemble those of other common respiratory illnesses, such as a
cold, the flu or bronchitis.

Sometimes, doctors diagnose whooping cough simply by asking about symptoms and
listening to the cough. Medical tests may be needed to confirm the diagnosis. Such
tests may include:

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A nose or throat culture and test. Your doctor takes a nose or throat swab or
suction sample. The sample is then sent to a lab and tested for whooping
cough bacteria.
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Blood tests. A blood sample may be drawn and sent to a lab to check for a

high white blood cell count. White blood cells help the body fight infections,
such as whooping cough. A high white cell count typically indicates the
presence of infection or inflammation. This is a general test and not specific
for whooping cough, however.

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A chest X-ray. Your doctor may order an X-ray to check for the presence of
fluid in your lungs, which can occur when pneumonia complicates whooping
cough and other respiratory infections.
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