Dr. Greene's Answer
Pertussis, or whooping cough, which once ravaged children around the world, is again on the rise. Worldwide, about 300,000 people die from the disease each year. Global travel can result in outbreaks anywhere. Pertussis is caused by bacteria that attach themselves to the cilia (little hairs) that line the respiratory tract. These bacteria produce a potent toxin that inflames the respiratory tract and that prevents the cilia from functioning properly. The disease can be serious or fatal in infants and unimmunized children. It is much milder in teens, adults, and in immunized children – but still can be a real nuisance. It can be far worse in people with asthma or with immune deficiencies. People with pertussis go through four stages:
- Incubation. For 5 to 21 days after exposure (usually 7 to 10 days) there are no symptoms at all while the bacteria multiply.
- Prodrome. For the next 1 to 2 weeks, pertussis is not unlike a cold. People have runny noses, sneezing, and perhaps a low-grade fever. A mild cough begins that gradually worsens.
- Paroxysms. The worst part of the illness lasts from 1 to 6 weeks. Spasms or attacks of coughing may come up to 15 times per day. Sometimes, especially in children, the cough is followed by a “whoop” noise as they breathe in rapidly, attempting to get air. Even so, young infants will often turn blue with the spells from lack of oxygen. The mucus is often thick and sticky. Gagging, choking, and vomiting are common. Sometimes young infants will stop breathing for varying lengths of time. This stage of pertussis is much milder in adults, teens, older children, and immunized children.
- Convalescence. As if this disease were not already long enough, the cough continues for another 2 to 4 weeks, but gradually becomes less severe and less frequent. Even after the cough seems finally over, the spasms often recur briefly for the next several months – especially during colds and during exertion.