Whooping cough | |
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Other names | Pertussis, 100-day cough |
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A young boy coughing due to pertussis. | |
Specialty | Infectious disease |
Symptoms | Runny nose, fever, cough[1] |
Complications | Vomiting, broken ribs, exhaustion[1][2] |
Duration | ~ 3 months[3] |
Causes | Bordetella pertussis (spread through the air)[4] |
Diagnostic method | Nasopharyngeal swab[5] |
Prevention | Pertussis vaccine[6] |
Treatment | Antibiotics (if started early)[7] |
Frequency | 16.3 million (2015)[8] |
Deaths | 58,700 (2015)[9] |
Whooping cough (/ˈhuːpɪŋ/), also known as pertussis or the 100-day cough, is a highly contagious, vaccine-preventable bacterial disease.[1][10] Initial symptoms are usually similar to those of the common cold with a runny nose, fever, and mild cough, but these are followed by two or three months of severe coughing fits.[1] Following a fit of coughing, a high-pitched whoop sound or gasp may occur as the person breathes in.[1] The violent coughing may last for 10 or more weeks, hence the phrase "100-day cough".[3] The cough may be so hard that it causes vomiting, rib fractures, and fatigue.[1][2] Children less than one year old may have little or no cough and instead have periods when they cannot breathe.[1] The incubation period is usually seven to ten days.[11] Disease may occur in those who have been vaccinated, but symptoms are typically milder.[1]
Pertussis is caused by the bacterium Bordetella pertussis, which is spread easily through the coughs and sneezes of an infected person.[4][12] People are infectious from the start of symptoms until about three weeks into the coughing fits.[7] Diagnosis is by collecting a sample from the back of the nose and throat.[5] This sample can then be tested either by culture or by polymerase chain reaction.[5]
Prevention is mainly by vaccination with the pertussis vaccine.[6] Initial immunization is recommended between six and eight weeks of age, with four doses to be given in the first two years of life.[13] Protection from pertussis decreases over time, so additional doses of vaccine are often recommended for older children and adults.[14] Vaccination during pregnancy is highly effective at protecting the infant from pertussis during their vulnerable early months of life, and is recommended in many countries.[15] Antibiotics may be used to prevent the disease in those who have been exposed and are at risk of severe disease.[16] In those with the disease, antibiotics are useful if started within three weeks of the initial symptoms, but otherwise have little effect in most people.[7] In pregnant women and children less than one year old, antibiotics are recommended within six weeks of symptom onset.[7] Antibiotics used include erythromycin, azithromycin, clarithromycin, or trimethoprim/sulfamethoxazole.[7] Evidence to support interventions for the cough, other than antibiotics, is poor.[17] About 50% of infected children less than a year old require hospitalization and nearly 0.5% (1 in 200) die.[1][2]
An estimated 16.3 million people worldwide were infected in 2015.[8] Most cases occur in the developing world, and people of all ages may be affected.[6][17] In 2015, pertussis resulted in 58,700 deaths – down from 138,000 deaths in 1990.[9][18] Outbreaks of the disease were first described in the 16th century.[11] The bacterium that causes the infection was discovered in 1906.[11] The pertussis vaccine became available in the 1940s.[11]