Pertussis, also known as whooping cough, is one of the fears of pediatricians when thinking about young infants. 

What is pertussis?

At first glace pertussis is a disease that looks very similar to a common cold initially-cough, runny nose, nasal congestion.  However, pertussis is sneaky. It starts out like any other illness, which we call the ‘catarrhal’ stage, which can last a week or more.  Then, the ‘paroxysmal’ stage starts, which is where we can see the typical coughing fit followed by the long ‘whoop’ inhale. This stage can last up to 6-10 weeks.  Finally, there is a ‘convalescent’ stage, where they slowly get better over the last few weeks.

So, during the catarrhal stage people can spread pertussis around without having any idea that they have it.  Also, even though we’ve all heard of the classic ‘whoop’, a lot of people will not actually do that, leaving the cause of the person’s illness unclear.  Pertussis in older adolescents and adults isn’t as bad as in the youngest group, so it’s not thought of. And finally, pertussis is thought of as a young person’s disease, so often it’s not even thought of.    

If all it causes is a cough and runny nose, what’s the big deal?

Our youngest patients, especially those who haven’t had their shots yet, can get the sickest with this disease.  Babies can not show any or just a little of the usual symptoms, and just stop breathing (apnea). According to the CDC, about half of the babies under a year who get pertussis will need to be cared for in the hospital.  Of the babies who need hospital treatment for pertussis 61% will have apnea, 23% will have pneumonia, 1.1% will have seizures, and 1% will die.          

What causes pertussis?

The bacteria that causes pertussis is called, unsurprisingly, Bordatella pertussis.  It is hard to grow in the lab, which used to mean it took several days to get the tests back.  Now we have testing that only takes a few hours, but in many places it can only be done in a hospital.

Can pertussis be treated?

Yes.  There are antibiotics that can be taken that will treat pertussis.  However, remember that the first few weeks are generally mild symptoms, so people are usually already spreading it before they are diagnosed and treated.  And that’s assuming they go to the doctor at all, and that the doctor tests for it.    

How can I prevent my baby from getting pertussis?

Babies get three pertussis shots before they are one year old.  However, since they can’t get the first one until they are 6-8 weeks old, there are several weeks where they are at risk for getting pertussis.

The best way to protect an infant from pertussis is for the mother to get the shot while she is still pregnant, usually the third trimester.  This allows time for mom to make antibodies which can then pass through the placenta for the baby to have. These can last up to 6-12 months.  

The next thing is to surround the baby with people who have been immunized.  Older siblings should be up to date on their immunization schedule, with older siblings getting the booster at 11 years old.  Adults that will be around the baby -dad, grandparents, babysitter, etc- need to go get the pertussis shot (aka Tdap, aka whooping cough shot) at least a few weeks before the baby is born if they aren’t already covered.  They can get this at a pharmacy, local health department, their doctor, or sometimes even the pediatrician.

Bottom line.

Pertussis can kill infants.  All it takes to protect your baby is a shot.  Make sure you get it.

Links.

Pertussis information at the CDC.

Pertussis at healthychildren.org.