Whooping cough, or pertussis, is a contagious childhood disease that is now rare in industrialized countries, thanks to immunization during infancy. The causative bacterium, Bordetella pertussis, is far from extinct, however; outbreaks still occur among unimmunized children. Half of all cases occur before age two, and children under 12 months are the most severely affected, with a mortality rate of 1 to 2 percent. About 7 to 14 days after exposure to the bacterium, the child develops what appears to be a lingering cold with a Whooping Cough.
Diagnostic Studies And Procedures
Early on, whooping cough is difficult to distinguish from other respiratory infections, but a laboratory culture can detect the causative bacterium. Fluorescent antibody testing of the sputum samples may also be performed to look for antibodies against B. pertussis.
Babies under six months old will usually be hospitalized; so, too, will older children who have severe symptoms. Choking is a major danger; infants may need suction to remove excess mucus, and some will require artificial respiration as well. Young babies may also require intravenous fluids and nutritional support. Otherwise, at the very least, bed rest is necessary, except for older children with mild cases. Antibiotics prescribed during the catarrhal stage may help shorten the course of the disease and lower the potential for passing it to others, but these drugs are of little or no benefit in the paroxysmal stage. Complications such as pneumonia and ear infections are also treated with antibiotics.
These can help during the convulsive stage, when coughing diminishes.
Thyme tea and baths are recommended for treating whooping cough. To prepare a thyme bath, add 5 or 6 tablespoons of dry thyme to a quart of boiling water. Let it stand for about 20 minutes, and then add it to the bathwater. Some herbalists prescribe a tea made from a combination of coltsfoot, mullein, and licorice, to be drunk three times a day. A young child may find it easier to cough while lying on her stomach with the head lowered and turned to one side to drain the lungs. An older child can clear sputum from the lungs by coughing while sitting up and leaning forward. cough. This catarrhal stage lasts for 7 to 10 days. Next follows the paroxysmal stage, marked by increasing production of sputum and frequent spells of violent coughing that end with a highpitched whooping sound while the child gasps for breath. Large amounts of thick mucus are brought up, and vomiting often follows a coughing attack. This stage lasts for two to four weeks, with the cough gradually diminishing as the child enters convalescence. Full recovery takes another three or four weeks. In some cases, however, the illness takes up to three months to run its course. Paroxysms of coughing may, in fact, recur for months, especially if the child catches a cold Whooping cough carries a risk of serious complications, including ear infections, pneumonia, and convulsions.
If the child is cared for at home, he will require close observation, especially during the paroxysmal stage. Keep him in bed in a quiet, darkened room; activity tends to provoke coughing. Give plenty of fluids to help thin mucus and then offer warm broth and steamy chicken soup to loosen it. Do not give over the counter remedies without checking with a doctor. Use a cool mist humidifier to help loosen sputum, and prepare small, frequent meals to help decrease vomiting. During a coughing bout, have a baby or young child lie on her stomach with the head lowered and turned to one side to help drain the lungs. It is crucial to keep a close watch and remove expelled secretions and vomit. Older children usually do better if they sit up and lean forward during paroxysmal coughing. Talk to your doctor about immunization of family members or children exposed to whooping cough. Prophy lactic erythromycin is recommended for household members and other close contacts, such as day care workers. Immunization or booster shots may be given to children, including those who have been immunized earlier.
Other Causes of Coughing
Many upper respiratory infections, including colds and flu, begin with symptoms similar to those of whooping cough. Bronchitis produces thick mucus but without paroxysmal coughing. Croup causes a barking, dry cough.