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In-Depth with Whooping Cough

separator Whooping cough is on the rise in the United States. According to the Centers for Disease Control and Prevention, there were 19,000 cases reported in 2004, which is nearly double the amount of cases reported in 2003. 

What causes it?
Whooping cough gets its name from the loud “whoop” noise people who have the disease make when they cough. It’s caused by a bacterium called Bordetella pertussis. (This is why whooping cough is also called “pertussis.”) When this bacterium gets inside your airway, toxins are produced. These toxins don’t allow your respiratory system to eliminate germs in the way that it normally would. Additionally, the pertussis bacteria cause inflammation, which damages the lining of the breathing passages.

How do you catch it?
Whooping cough is highly contagious. About 90 percent of the people living in a household with someone who has whooping cough will contract the disease if they don’t have sufficient immunity to it.

You catch whooping cough from inhaling the droplets from the coughing and sneezing of someone who has the disease. It’s most contagious early in the disease. At that point, you often don’t realize you have whooping cough because it seems like a common cold. So it’s easy to unknowingly pass it on to others you come in contact with.

How whooping cough progresses
Whooping cough usually starts with symptoms that would make you think you have a cold:

  • Runny nose
  • Sneezing
  • Eye irritation
  • Occasional cough
  • Mild fever

After a week or two, the symptoms become more severe and include

  • Violent coughing, with a deep gasping in between coughs. The gasp sounds like a “whoop.”
  • Coughing that can trigger vomiting

The coughing can be so severe that it may cause your ribs to break. Pneumonia, dehydration and seizures can also result. In fact, pneumonia develops in about 30 to 40 percent of cases. It’s the most common complication and the most common cause of death among people who contract whooping cough.

The whooping cough attacks occur most often at night, when you’re trying to sleep. People who have whooping cough generally suffer from lack of sleep and they often feel exhausted.

Unfortunately, whooping cough can last for about six to eight weeks. The actual cough gets better, but it can linger for months.

How is it treated?
Doctors diagnose whooping cough by taking samples of the mucous from your nose or throat. The presence of the pertussis bacterium confirms the diagnosis. Your doctor may also want to do a blood test and take an X-ray of your chest.

If you detect whooping cough in the first week, it’s possible that an antibiotic, most likely erythromycin, may help decrease the severity and shorten the length of time that you have the disease. After the first week, erythromycin isn’t effective for many people, but it’s important to follow the drug regimen your doctor has prescribed. Antibiotics play an important role in helping to stop the spread of whooping cough to other members of your household. It’s likely that your doctor will recommend that other members of the household start on the antibiotic regimen. This could prevent them from coming down with the disease. This is true for others who frequently come in contact with someone who has whooping cough, such as day care staff and teachers.

Over-the-counter cough medicines, including cough expectorants and suppressants (in syrup or drop form) typically provide little to no relief to whooping cough sufferers. Guidelines from the American College of Chest Physicians recommend that adults try older antihistamines that contain decongestants.

Children who develop whooping cough often need to get treatment in the hospital. Nearly all babies under six months old go to the hospital if they develop the disease, and 40 percent of babies older than six months are hospitalized. Often, these children develop pneumonia as a complication. At the hospital, mucous may be suctioned from the airways. Children may need oxygen to help them breathe. The breathing will be constantly monitored.

People who have whooping cough should make sure to drink plenty of fluid because the vomiting that often results from the severe coughing can cause you to become dehydrated.

Who’s most at risk?

  • Children too young to be vaccinated
  • People who haven’t completed the full vaccination schedule
  • People who have not had booster shots

How can you prevent whooping cough?
Whooping cough can be prevented if you receive the full schedule of DTP immunizations. This stands for diphtheria, tetanus and acellular pertussis. Children generally receive these shots in five doses before their sixth birthday.

People often think of whooping cough as a childhood disease, but it’s becoming more common in adolescents and adults. In fact, adults currently comprise about 28 percent of whooping cough cases.

The whooping cough vaccine typically lasts only for about five to 10 years. If you had your pertussis vaccine long ago, and you haven’t had a booster shot since then, it’s likely that you’re no longer protected against the disease. That’s why the American College of Chest Physicians recently recommended that adults up to 65 years old get a new, adult vaccine for whooping cough.

National Institutes of Health, National Library of Medicine
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