Whooping Cough in Children: Symptoms, Diagnosis, and Prevention
What causes whooping cough?
Whooping cough (Pertussis) is a respiratory disease caused by the bacterium Bordetella pertussis. It spreads through respiratory droplets or contact with secretions from infected individuals. It is highly contagious, especially among those without immunity. While commonly seen in children, adults can also contract it—though symptoms tend to be milder or absent.
What are the symptoms of whooping cough?
After exposure, the incubation period lasts about 6–20 days. Symptoms progress in three stages:
Initial Stage:
- Symptoms resemble the common cold: mild fever, runny nose, nasal congestion, cough, and red eyes.
- This is the most contagious phase.
- This stage lasts 1–2 weeks with a gradually worsening cough.
Paroxysmal Stage:
- Severe coughing fits without pauses—5 to 10 in a row—followed by a high-pitched “whoop” sound during inhalation.
- Infants under 6 months may have cyanosis, complications like subconjunctival hemorrhage, pneumonia, difficulty breathing, apnea, vomiting, dehydration, or seizures.
- This stage lasts 2–4 weeks.
Recovery Stage:
- Cough gradually improves and typically resolves within 6–10 weeks.
How is whooping cough diagnosed?
In addition to history taking and physical examination, laboratory tests are used. These include complete blood count, culture or PCR testing of nasopharyngeal swabs to detect Bordetella pertussis—especially effective in the first 1–2 weeks of symptoms.
How is whooping cough treated?
- Early administration of macrolide antibiotics (e.g., erythromycin, azithromycin, clarithromycin) helps reduce severity. Although less effective if given after 1 week of symptoms, they still help prevent transmission.
- Supportive care includes avoiding cough triggers, adequate rest, fever-reducing medications, and fluid replacement.
How to prevent whooping cough?
Vaccination is the most effective way to prevent whooping cough.
- All Thai children should be vaccinated at 2, 4, 6, and 18 months, then receive boosters at 4–6 years old, and periodically thereafter.
- Pregnant women between 27–36 weeks gestation should receive a vaccine to pass immunity to the fetus.
- Close contacts of infected individuals or those at high risk may receive antibiotics to prevent illness and should be monitored for at least 2 weeks.
- Good hygiene practices—frequent hand washing, covering mouth and nose when coughing/sneezing, wearing masks, avoiding crowded places, and staying away from sick individuals—are essential.
