Whooping Cough (Pertussis)

Pertussis in Children: Symptoms, Causes, Treatment, and Prevention

Pertussis, also known as whooping cough, is a respiratory tract infection that can occur at any age but is particularly severe in young children who have not completed their vaccinations or lack immunity. Parents should seek medical attention immediately if their child shows persistent dry cough and low-grade fever over several days. Early intervention helps ensure proper treatment and prevents complications.

Symptoms of Pertussis

Pertussis has an incubation period of about 7–10 days, extending up to 20 days in some cases. Symptoms are typically categorized into three stages:

1. Catarrhal Stage

  • Symptoms: Early signs resemble the common cold, including cough, runny nose, red eyes, watery eyes, and occasionally low-grade fever.
  • Duration: This stage usually lasts 1–2 weeks.
  • Contagion: The disease is most contagious during this period.

2. Paroxysmal Stage

  • Symptoms: Severe, repeated coughing fits occur, sometimes causing breathing cessation, cyanosis (blue face), or vomiting. Infants may experience respiratory arrest.
  • Duration: This stage lasts around 2–4 weeks or longer in severe cases.

3. Convalescent Stage

  • Symptoms: The cough gradually subsides over 2–3 weeks.
  • Duration: The overall duration of the illness typically spans 6–10 weeks if no complications arise.

Causes and Transmission of Pertussis

Pertussis is caused by the bacterium Bordetella pertussis. It spreads through respiratory droplets from coughing, sneezing, or nasal secretions of infected individuals. Adults with mild symptoms often serve as carriers, unknowingly transmitting the infection to unvaccinated children.

Potential Complications

In young children, particularly those under 1 year old, pertussis can lead to severe complications, including:

  • Pneumonia: The leading cause of pertussis-related deaths.
  • Apnea: Respiratory arrest, especially in infants under 3 months.
  • Subconjunctival Hemorrhage: Caused by intense coughing.
  • Seizures: Rare but possible in severe cases.

Diagnosis of Pertussis

Accurate diagnosis involves culturing bacteria from nasal secretions, though this can be challenging. Polymerase chain reaction (PCR) testing for bacterial genetic material is another option but is costly and usually available only in large hospitals.

Treatment of Pertussis

Treatment primarily involves antibiotics. It is most effective when administered within the first 3–4 days of symptom onset.

  • If initiated later, antibiotics may reduce contagion but do not significantly shorten the illness duration.
  • Severe cases in infants often require hospitalization for supportive care.

Preventing Pertussis

The most effective prevention is vaccination. The Pediatric Infectious Disease Society of Thailand recommends the following vaccination schedule:

Vaccination Schedule for Children

  1. At 2 months
  2. At 4 months
  3. At 6 months
  4. Booster at 18 months
  5. Booster at 4–6 years

Vaccination for Pregnant Women

Expectant mothers should receive the pertussis vaccine between 27 and 36 weeks of pregnancy. This protects both the mother and the infant through passive immunity transfer.

Vaccination for Adults Around Infants

Family members and caregivers living with infants should also receive the pertussis vaccine to prevent transmission.

Additional Precautions and Recommendations

  • If your child has a persistent cough lasting 2–3 weeks, consult a doctor immediately.
  • Keep infants away from individuals with cough or cold symptoms.
  • Encourage hand hygiene and maintain a clean living environment to minimize the risk of infection.

By understanding the nature of pertussis and ensuring appropriate preventive measures, you can protect your child and help them grow up healthy and strong.

Frequently Asked Questions (FAQs)

1. How is pertussis transmitted?
Pertussis spreads through respiratory droplets when an infected person coughs or sneezes.

2. Is the pertussis vaccine safe?
Yes, the vaccine is safe and highly effective in preventing pertussis.

3. Why are infants more severely affected than adults?
Infants lack fully developed immune systems and respiratory functions, making them more vulnerable to severe symptoms.

4. Do pregnant women need the pertussis vaccine?
Yes, it provides immunity to the mother and her unborn child, reducing the risk of severe pertussis in infants.

5. What should I do if I suspect my child has pertussis?
Seek immediate medical attention to ensure accurate diagnosis and timely treatment.

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