9 things parents need to know about whooping cough

Outbreaks of whooping cough occur every year in Canada and around the world. Here are the facts on how it spreads, the symptoms and vaccination.

Photo: iStock
Photo: iStockphoto

1. Whooping cough is highly contagious.
Whooping cough—also called pertussis—is a bacterial infection that spreads when a person who has the illness coughs or sneezes near others. It’s so contagious that if someone in your home has whooping cough, there’s an 80 percent chance a susceptible person in the family, like a baby, will develop this infection. Babies and young children most often get the illness from older siblings, parents and caregivers.

The good news: because whooping cough is caused by bacteria, it can be treated with antibiotics. The bad news: There’s not much that can be done to help the cough. (Over-the-counter cough medications aren’t recommended.)

If you or your child is diagnosed with whooping cough, your doctor may prescribe antibiotics to other family members to prevent it from spreading to others.

2. Whooping cough is preventable.
Pertussis immunization in recommended by health agencies in Canada, the US and other countries around the world. Before a vaccine became widely available in the 1940s, up to 19,800 kids in Canada and about 200,000 kids in the US became ill each year. Whooping cough rates have dropped dramatically (up to 90 percent, according to the World Health Organization), but outbreaks still occur.

If you’re following your provincial and territorial immunization schedule, your kids will get a combination vaccine for diphtheria, tetanus and acellular pertussis, at two, four, six and 18 months. After three doses, the vaccine is believed to be 80–85 percent effective.

A booster shot between ages four and six and another in adolescence (between grades seven and nine, or ages 14 and 16, depending on where you live) are also recommended.

3. Symptoms first resemble a cold, but you’ll soon get coughing attacks.
Symptoms of whooping cough usually appear seven to 10 days after exposure to the bacteria (though it may be longer), and they initially resemble the common cold: runny nose, mild cough, sneezing, low-grade fever and red, watery eyes.

Over the next week or two, the cough worsens. During coughing attacks, you may hear the characteristic high-pitched “whoop” on an inhale following a cough. Coughing attacks can cause vomiting, a red or blue face and extreme fatigue. Some people may also struggle to breathe or experience pauses in breathing. If you or your child develop any of these symptoms, see a doctor.

4. Young babies, adolescents and adults may not have the telltale “whoop” symptom.
The characteristic “whoop” inhalation following a cough isn’t common among adults, adolescents and kids who’ve been partially immunized, and some teens and adults may have no symptoms at all.

Babies can be especially difficult to diagnose because they may have none of the typical symptoms—not even a cough. They may instead struggle to breathe or temporarily stop breathing; you should see a doctor immediately if this occurs.

5. If you have whooping cough, you could be contagious for nearly a month.
A person with whooping cough is considered contagious from the first sign of symptoms until three weeks after the onset of coughing—typically a span of about four or five weeks. However, a person will no longer be infectious after five days of antibiotic treatment.

Kids and caregivers, in particular, should stay home for the first five days of antibiotic treatment, or three weeks from the onset of the cough if they’re not being treated with antibiotics.

While whooping cough symptoms typically peak between two and five weeks, full recovery can take weeks or months longer.

6. Babies are at greatest risk of serious complications and even death.
Babies under six months are most at risk of developing whooping cough because they haven’t yet received three vaccinations, and they’re more likely to experience severe complications. They can become dangerously dehydrated and experience weight loss because they aren’t eating. Other complications include bacterial pneumonia, collapsed lung, seizures and even brain damage.

These complications can be deadly: Whooping cough kills about one to four people in Canada and 10 to 20 people in the US each year—usually babies who are too young to be immunized or young kids who are not immunized or partially immunized.

7. Side effects in teens and adults are less severe, but may be very unpleasant.
Coughing attacks can lead to bruised or cracked ribs and abdominal hernia. They can also cause the blood vessels to break in your skin or in the whites of your eyes. Sleep is often affected by persistent coughing. In extreme cases, the pressure from extreme coughing attacks can cause urinary incontinence (involuntary peeing) or rectal prolapse (when a portion or all of the rectum is pushed out of the anus).

8. Health agencies recommend a booster shot for adults.
If you haven’t had a pertussis booster shot as an adult, the federal health agencies in Canada and the US recommend you do.

The Public Health Agency of Canada also advises pregnant women to get a dose of the pertussis vaccine at or after 26 weeks gestation if they haven’t been vaccinated as an adult, or if there’s a regional outbreak. Vaccination at this stage of pregnancy allows antibodies to transfer from mom to fetus, offering early protection for newborns. The vaccination will also help prevent Mom from contracting the illness and passing it on to baby.

9. Babies may be protected through “cocooning” vaccination.
The theory behind cocooning is that if the people who are around a baby are vaccinated, then they won’t contract the illness and pass it on to the vulnerable infant. The Public Health Agency of Canada recommends all adults who will be in regular contact with a baby get their adult booster shot at least two weeks before contact with the baby.

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