Paediatrics => Whooping Cough
Whooping Cough, common name applied to an acute, infectious disease of the respiratory tract, caused by the bacillus Bordetella pertussis. The disease, known medically as pertussis, is characterized in its late stages by a deep cough ending in a peculiar high-pitched whooping sound. Infection is transmitted by direct contact, usually by means of droplets sprayed into the air during coughing spells. Whooping cough is worldwide in distribution and occurs periodically in epidemics. Most cases occur in children under five years of age, with children less than one year old being the most seriously affected.
The disease begins with a runny nose, a harsh cough, and a slight fever. The characteristic whoop develops one to two weeks later. Coughing spells, which usually occur at night and often end in vomiting, can continue to occur for four weeks or more. Complications of pertussis may include pneumonia and involvement of the central nervous system with blood loss, or hemorrhage.
Treatment for whooping cough aims at controlling the coughing with sedatives and replacing fluids lost by vomiting. Use of pertussis vaccine during the first year of life provides immunity to the infection in most children. Pertussis vaccine is usually given together with diphtheria and tetanus vaccines in a shot called DPT. In 1996 laws requiring school children to be immunized against pertussis existed in 42 of the 50 states, and children entering day care were required to be immunized against pertussis in 48 states. As a result of this extensive immunization, mortality from pertussis in the United States has dropped to about ten cases per year.
A drawback of the traditional pertussis vaccine, which is made from killed whole-cell pertussis bacteria, is that it commonly causes side effects such as fever, irritability, and swelling. However, by 1996 several new acellular pertussis vaccines had been approved by the Food and Drug Administration for booster shots in older children and were being tested for use in infants. These acellular vaccines cause fewer side effects than whole-cell pertussis vaccine because they are made from only parts of the killed bacterial cells. Acellular pertussis vaccine is also given together with diphtheria and tetanus vaccines in a shot called DaPt.