Cough (Whooping)

A whooping cough, also known as pertussis, is a highly contagious respiratory illness caused by the bacterium Bordetella pertussis. The characteristic symptom of this condition is a severe, persistent cough that sounds like a "whoop" and is often accompanied by vomiting after coughing.

Causes and Risk Factors

The primary cause of whooping cough is the Bordetella pertussis bacterium. The risk factors for contracting this illness include:

• Lack of vaccination or incomplete vaccination series against pertussis
• Close contact with someone who has the infection
• Age, as it most commonly affects infants and young children, although adults can also be infected if their immunity has waned
• Weakened immune system due to other health conditions or treatments

Symptoms

The symptoms of whooping cough typically progress through several stages:

• Initial Stage (1-2 weeks): Mild respiratory symptoms such as a runny nose, sneezing, mild cough, and low-grade fever.
• Paroxysmal Stage (2-4 weeks or longer): The characteristic whooping cough develops. Coughing fits or paroxysms can occur, often ending with a high-pitched intake of breath that sounds like "whoop." Vomiting may follow these coughing spells.
• Convalescent Stage (weeks to months): The frequency and severity of the coughing fits gradually decrease over time.

Diagnosis

Diagnosing whooping cough involves a combination of clinical evaluation, laboratory tests, and sometimes imaging studies:

• Clinical diagnosis based on symptoms, especially the characteristic whoop sound during coughing fits
• Polymerase chain reaction (PCR) test to detect the genetic material of Bordetella pertussis in respiratory secretions
• Culture of respiratory secretions, though this method is less sensitive than PCR
• Serologic tests to measure antibodies against B. pertussis, useful in certain cases or for epidemiological studies

Treatment and Prevention

Treatment focuses on alleviating symptoms, preventing complications, and reducing the risk of transmission:

• Antibiotics (such as azithromycin or clarithromycin) to treat the infection, especially if started early in the course of the disease. Antibiotics are most effective when given during the initial stages before the paroxysmal phase.
• Symptomatic relief measures such as maintaining hydration, rest, and using a humidifier to relieve cough
• Vaccination is the primary method of prevention. The pertussis vaccine is included in combination vaccines (DTaP for children and Tdap for adolescents and adults) that protect against diphtheria, tetanus, and pertussis.
• Isolation to prevent spread until the individual has completed a course of antibiotics or for a specified period if not treated with antibiotics

Complications

Possible complications of whooping cough include:

• Pneumonia, which can be severe and life-threatening, especially in infants
• Convulsions (seizures)
• Encephalopathy (brain disease, damage, or malfunction)
• Malnutrition due to persistent vomiting after coughing fits
• Pneumothorax (collapsed lung) and subcutaneous emphysema (air trapped under the skin) from severe coughing

Prognosis

The prognosis for whooping cough is generally good, especially with prompt treatment. However, it can be severe in infants younger than 6 months old and in individuals with certain underlying health conditions.