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Whooping cough, also known as pertussis, is a very contagious respiratory illness. It is caused by a type of bacteria called Bordetella pertussis. This disease is only found in humans.

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Transmission is by droplets. The bacteria colonize only ciliated cells of the respiratory mucosa, and they multiply rapidly.

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Bordetella is a Gram-negative, pleomorphic, aerobic coccobacillus. It is encapsulated, does not produce spores and is a strict aerobe. It is arranged singly or in small groups

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The virulence factors include adhesins such as filamentous hemagglutinin, fimbriae and pertactin, which allow Bordetella pertussis to bind to ciliated epithelial cells in the upper respiratory tract. One of the first tools it uses to cause disease is filamentous hemagglutinin (FHA), a surface protein that helps the bacteria adhere to ciliated cells in the respiratory tract. Along with pertactin, another adhesion protein, Bordetella pertussis manages to stick around and avoid being cleared by the body’s immune defenses.The bacteria also produces a powerful toxin called pertussis toxin (PT). This toxin disrupts the normal functioning of immune cells by interfering with their signaling pathways. This impairment weakens the immune response, allowing the bacteria to multiply and persist in the body longer.Another important toxin is tracheal cytotoxin (TCT), which damages the ciliated cells, impairing the body’s ability to clear mucus from the lungs. This leads to the violent, persistent coughing fits that are the hallmark of whooping cough.

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Doctors take a nose and throat swab, so they can test for the Bordetella pertussis bacteria in culture or a more rapid polymerase chain reaction test. Your doctor may suggest a blood test to check your white blood cell count, which, if low, signals the presence of an infection.

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Long term complications fall into 3 major groups: pulmonary, neurologic, and nutritional. The most frequent are pulmonary complications including both interstitial and alveolar pneumonia and, in severe cases, respiratory failure. Autopsy findings demonstrate lungs filled with inflammatory cells, fibrinous edema, and abundant pertussis bacteria. Neurological complications of pertussis are also reported. Nutritional deficiencies can also arise during pertussis illness, due to the difficulty of feeding in the face of paroxysms of cough and the consequences of continuous vomiting. In infants, the disease can cause pneumonia, seizures, brain damage or even death. In adults, complications are less common but may include rib fractures from severe coughing or secondary respiratory infections.

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Whooping cough, a highly communicable, worldwide infection, was once common and dangerous, killing many thousands of children per year. Widespread vaccination has caused a continuous decrease in incidence and mortality over the years, but large numbers of patients still die in countries where vaccination is inadequate.

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2. PERTUSSIS SYMPTOMS ARE DIFFERENT IN BABIES.

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2. PERTUSSIS SYMPTOMS ARE DIFFERENT IN BABIES.

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Some babies who get pertussis won’t cough at all. Instead, they will stop breathing or have pauses in their breathing (apnea). And they may even turn blue. Call 911 if this happens.

Babies are at the greatest risk of complications from whooping cough. According to the CDC, 1 in 3 babies younger than 1 year old will need hospital care.

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3. WHOOPING COUGH STARTS OUT MILD, LIKE ANY OTHER COLD.

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3. WHOOPING COUGH STARTS OUT MILD, LIKE ANY OTHER COLD.

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Typical early symptoms of pertussis are a runny nose, low-grade fever and mild cough. Because of this, whooping cough is often not diagnosed until the more severe symptoms appear. If your child’s cough has gone on for longer than 10 days and doesn’t seem to be getting better, consider going to see your doctor to make sure nothing else is going on.

Early treatment of pertussis can be helpful because it may prevent the severe symptoms from happening. Plus, it may also help avoid its spread to other people.

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4. YOUR CHILD CAN STILL GET PERTUSSIS EVEN IF VACCINATED. 

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4. YOUR CHILD CAN STILL GET PERTUSSIS EVEN IF VACCINATED. 

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That being said, vaccination is the best protection against whooping cough that we have. Studies show that vaccinated individuals who become infected with the illness have milder symptoms. The CDC states that after children receive their last dose of the DTaP vaccine (between ages 4-6 years), 7 out of 10 are fully protected for five years.

We also recommend a booster vaccine (Tdap) at ages 11-12 years.

It is also great to make sure that your child’s pertussis vaccine is current. And if you have a baby younger than 1 year old, be extra vigilant about hand washing and steering clear of extended family members who may have long-lasting coughs.

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About whooping cough. (2024, April 2). Whooping Cough (Pertussis). https://www.cdc.gov/pertussis/about/index.html#:~:text=Whooping%20cough%20is%20a%20respiratory,of%20the%20upper%20respiratory%20system.

DeBlasio, N., MD. (2024, October 1). 4 Must-Know Facts about Whooping Cough. Cincinnati Children’s Blog. https://blog.cincinnatichildrens.org/safety-and-prevention/4-surprising-facts-whooping-cough-pertussis/

Finger, H., & Von Koenig, C. H. W. (1996). Bordetella. Medical Microbiology - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK7813/#:~:text=Bordetella%20pertussis%20causes%20whooping%20cough,are%20bronchopneumonia%20and%20acute%20encephalopathy.

Nieves, D. J., & Heininger, U. (2016). Bordetella pertussis. Microbiology Spectrum, 4(3). https://doi.org/10.1128/microbiolspec.ei10-0008-2015

Orenstein, W. A. (1999). Pertussis in Adults: Epidemiology, Signs, Symptoms, and Implications for Vaccination. Clinical Infectious Diseases, 28, S147–S150. http://www.jstor.org/stable/4481911

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The illness is characterized by coughing spells that end with a characteristic "whoop" as air is inhaled.These intense coughing spells will often result in loss of bladder control, vomiting and cause exhaustion, light-headedness and headaches. The lips and areas around the lips may even turn blue immediately after a coughing spell.

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1. NOT EVERYONE MAKES THE WHOOPING SOUND.

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1. NOT EVERYONE MAKES THE WHOOPING SOUND.

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The “whooping” noise when coughing is the hallmark of the illness. However, not everyone who has whooping cough, also known as pertussis, makes that noise. And the condition can still be just as dangerous to children even if they’re not making the whooping sound.

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The best way to prevent whooping cough is to get vaccinated. Tdap is a combination of three vaccines that protect against tetanus, diphtheria, and pertussis. The vaccine produces an active immune response in the body by developing antibodies and antitoxins against the toxoids and acellular pertussis antigens.

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Treatment options depend on the stage of disease. In the early stages options are fairly standard and the preferred agents include a short treatment of macrolide antibiotics such as azithromycin or erythromycin. Antibiotics have no effect on the clinical symptoms or course of pertussis but are prescribed primarily to eradicate Bordetella pertussis from the nasopharynx and to limit the spread of infection. Much of the morbidity of whooping cough is due to the effects of the paroxysmal cough.