Whooping Cough. The Lungs Whooping cough is an infection of the lungs and breathing tubes, both of which are parts of the respiratory system.

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1 Whooping Cough Introduction Whooping cough is a serious bacterial infection of the lungs and breathing tubes. It is also called pertussis. About 16 million cases of whooping cough happen worldwide each year. Most of these cases happen in developing countries. Whooping cough spreads very easily. Preventing whooping cough is always better than treating it. If you do get whooping cough, your best chance of getting better is knowing the symptoms and getting treatment right away. This reference summary will help you better understand whooping cough. It covers the causes and diagnosis of whooping cough as well as its treatment options. The summary also reviews how to prevent whooping cough. The Lungs Whooping cough is an infection of the lungs and breathing tubes, both of which are parts of the respiratory system. The lungs allow us to fill our blood with oxygen. The oxygen we breathe is absorbed into our blood through tissue in the lungs. When we breathe in, the air goes through our mouth and our nose. From there it goes to the throat, also known as pharynx. The pharynx divides into two tubes near the top of the neck. It divides into: 1. The windpipe at the front, known as the larynx and trachea, which goes to the lungs. 2. The tube at the back, known as the esophagus, which goes to the stomach. Windpipe Esophagus 1

2 From the windpipe, air goes into a number of increasingly smaller tubes called bronchial tubes. These are located on each side of the lungs. Small balloon-like sacs called alveoli are at the end of the bronchial tubes. The alveoli are very thin. Oxygen goes from the air into the blood through the alveoli. At the same time, carbon dioxide leaves the blood through the alveoli and goes into the lungs where it is exhaled. The inner lining of the bronchial tubes produces a special substance called mucus. Mucus helps trap dirt from the air. Mucus is constantly expelled from our lungs. Very small brushes called cilia protect the respiratory tract. The cilia constantly push the mucus out of the lungs. Most of the time the mucus is pushed automatically. If there is too much mucus, it can be coughed out. When the air we breathe contains germs, our immune system protects the respiratory system from infection. Sometimes germs can get past the defenses of the respiratory system causing whooping cough. Alveoli Whooping Cough Whooping cough is an inflammation and infection of the lungs and breathing tubes. Inflammation is the immune system s normal response to injury or contaminants. Germs, bacteria, and viruses are contaminants and can cause inflammation. Whooping cough is caused by a certain type of bacteria. These bacteria attach to the cilia that line part of the upper respiratory system. The bacteria release poisons known as toxins. The toxins released by the bacteria damage the cilia and cause inflammation. The inflammation of the lungs and breathing tubes makes it hard to breathe. Whooping cough is most common in babies and young children. Whooping cough is very dangerous for infants. Over half of children younger than 1 year of age with whooping cough need to stay in the hospital. The younger the infant, the more likely treatment in the hospital will be needed. Rarely, whooping cough can be deadly. 2

3 Teens and adults can also experience complications from whooping cough. Complications in this older age group are usually caused by the cough itself. The most common complications for teens and adults include: Weight loss Loss of bladder control Passing out Rib fractures from severe coughing Symptoms Whooping cough usually begins with cold-like symptoms, like a runny nose or sore throat. It may also start with a mild cough or fever. After 1 to 2 weeks, severe coughing usually begins. Whooping cough can cause violent coughing, over and over, until a person cannot push anymore air out of the lungs. This forces a person with whooping cough to inhale with a loud whooping sound. A person may still have whooping cough without the whooping sound. People who have been vaccinated and still get whooping cough are less likely to make the whooping sound. Babies with whooping cough may not cough or may have a mild cough. Babies are more likely to have apnea instead. Apnea is a temporary pause in breathing. Since whooping cough starts with the same symptoms as the common cold, it may not be diagnosed until more severe symptoms appear. These more severe symptoms can include: Coughing fits of many, rapid coughs followed by a high-pitched whoop Vomiting Tiredness after coughing fits A person with whooping cough is contagious for about 2 weeks after the cough begins. Antibiotics may shorten the time that a person is contagious. Coughing fits from whooping cough may continue for up to 10 weeks or longer. Slowly, the cough will become less severe and less common. 3

4 When to See a Doctor If you think you have whooping cough, you should contact your healthcare provider. If antibiotics are given soon enough, they may lessen the time that you are contagious. You should also contact your healthcare provider if your coldlike symptoms do not improve after one or two weeks. You may have a milder form of whooping cough that doesn t cause you to cough or make the whooping sound. Make sure to take your child to the pediatrician if you suspect he or she has whooping cough. Whooping cough is most severe in babies younger than 1 year of age. Babies may need to stay in the hospital. Diagnosis The first consideration in diagnosing whooping cough is whether you know you have been exposed to it. For example, if someone in your family has recently had whooping cough you are more likely to have it. However, you may get whooping cough without knowing that you have been exposed. During your appointment, your healthcare provider will ask you to describe your symptoms. Your healthcare provider may also perform a physical exam to check for signs of whooping cough. Lab tests can confirm the diagnosis of whooping cough. Lab tests may include blood tests or taking samples of mucus from the back of the throat through the nose. Lab tests look for the specific bacteria that cause whooping cough. Treatment Treating whooping cough early is very important. Starting treatment before coughing fits begin may make the infection less severe. Treating whooping cough early also helps prevent the spread of the disease to the people around you. Since whooping cough is highly contagious, it is important to treat it as early as possible. 4

5 Antibiotics may be given to treat whooping cough in its early stages. Antibiotics can kill the bacteria that cause whooping cough. Take all of your prescribed medications. Stopping prescribed medication too soon could cause whooping cough to come back and make it harder to treat. Follow the instructions that came with your medicine and take all the prescribed doses on time. Antibiotics usually don t help if they are started after 3 or 4 weeks of having whooping cough. The bacteria are already gone from your body at this point. However, you will still have symptoms because the bacteria have already damaged your respiratory system. Cough medicines are not recommended. Often cough medicines don t help with whooping cough. To improve symptoms of whooping cough, you should keep your home free from irritants. Irritants like smoke, dust, and chemical fumes can trigger coughing fits. You can also use a cool mist vaporizer to loosen mucus and soothe the cough. Treating whooping cough includes drinking plenty of fluids to prevent dehydration. Drinking fluids also loosens mucus. You can also eat smaller, more frequent meals if coughing fits are causing vomiting. Some children may need to stay in the hospital for treatment. This is to make sure their breathing passages clear. Oxygen and IV fluids can also be given to children if needed. Prevention Whooping cough is highly contagious. The bacteria that cause whooping cough can be spread by coughing and sneezing. The best way to prevent whooping cough is to recommendations depend on a person s age. get vaccinated. Vaccination The recommended whooping cough vaccine for infants and children in the United States is called DTaP. This vaccine protects against three diseases: diphtheria, 5

6 tetanus, and pertussis. In DTaP, the D stands for diphtheria, T for tetanus, and the P for pertussis. Diphtheria is a serious respiratory disease caused by bacteria. The bacteria can enter the body through contact with someone who is infected. If not properly diagnosed and treated, it can produce a poison that causes many complications in the body. Tetanus is a serious illness caused by tetanus bacteria. The bacteria can enter the body through a cut or wound. It can cause tightening of the muscles and other serious complications. Pertussis is another name for whooping cough. Children should get 5 DTaP shots. The first 3 shots are given at 2, 4, and 6 months of age. The fourth shot is given between 15 and 18 months of age. The fifth shot is given before a child enters school at 4-6 years of age. Vaccine protection for pertussis, tetanus, and diphtheria fades with time. Booster vaccinations called Tdap are available for pre-teens, teens, and adults. Pre-teens should get a dose of Tdap at age 11 or 12. Teens that didn t get the booster at 11 or 12 should get one at their next visit. Adults should also get a Td vaccine every 10 years. Adults who didn t get the Tdap as a pre-teen or teen should get one dose of Tdap by substituting a Tdap vaccine for one Td vaccine. A Td vaccine is a tetanus and diphtheria booster. It doesn t contain a pertussis booster. It is especially important that people who are around children be vaccinated against whooping cough. This includes pregnant women, grandparents, families, and caregivers. These people should be vaccinated at least 2 weeks before having close contact with babies. Pregnant women that have not previously had a Tdap vaccine should be vaccinated after 20 weeks of pregnancy. If they are not vaccinated during pregnancy, they should receive one dose of Tdap after delivery before they leave the hospital. Another important way to prevent whooping cough is to stay away from people that you know have whooping cough. You should also avoid contact with 6

7 people that have cold symptoms and are coughing. Whooping cough often begins with symptoms similar to the common cold. If you can t avoid contact with infected people, make sure to follow good hygiene habits: Wash your hands often with warm soapy water Use alcohol-based gel for hand washing when soap and water are not available Use separate drinking glasses and eating utensils Wear a surgical mask Summary Whooping cough is a serious bacterial infection of the lungs and breathing tubes. It is highly contagious and very dangerous for babies. The best way to prevent whooping cough is by getting vaccinated. You can also help prevent whooping cough by: Washing your hands often with warm soapy water Using alcohol-based gel for hand washing when soap and water are not available Using separate drinking glasses and eating utensils Preventing whooping cough is always better than treating it. If you do get whooping cough, your best chance of getting better is knowing the symptoms and getting treatment right away. 7

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