What is pertussis (whooping cough)?
Whooping cough is a very serious infection of the lungs and airways caused by the Bordetella pertussis bacteria. Symptoms can begin anywhere from 5 to 21 days after exposure, but typically starts seven to 10 days after exposure.
How does it spread?
Pertussis is a very contagious illness and spreads easily between people when an infected person talks, coughs or sneezes.
Infected individuals can spread the illness for three weeks after the start of the cough if antibiotic treatment is not received.
Pertussis is most dangerous for infants under the age of one year. Many babies who are not yet protected fully from immunization get pertussis from older contacts who may not be aware they have the illness. About half of babies under one year old need to be hospitalized, and about one in four will develop pneumonia.
What are the symptoms of pertussis?
Pertussis usually begins with a runny nose, mild fever, red watery eyes and mild cough seven to ten days after being infected with the bacteria.
After one to two weeks, the cough becomes more frequent and severe, sometimes ending in gagging, choking, vomiting, exhaustion or trouble breathing. Some babies and young children may have a mild cough but experience apnea (life-threatening pauses in breathing) instead.
When children gasp for breath after a coughing fit, they may make a "whoop" sound before the next breath. Babies may not make this sound.
- Coughing fits can make it hard to eat, drink or sleep. Coughing happens more at night.
- Coughing fits may last for 10 weeks and may recur with the next respiratory illness.
Can Pertussis cause serious illness or complications?
Yes. Babies and young children may have spells where they don’t breathe causing them to turn blue from lack of oxygen.
Infants under one year of age usually need to be hospitalized.
Very rarely, pertussis can cause seizures, brain damage or death.
Older children and adults may cough so hard that they break a rib, lose control of their urine or collapse a lung.
Diagnosis and treatment
If you think you or a child may have pertussis, contact a healthcare provider. Early treatment is more effective in preventing severe coughing.
Tell the health care provider that you think you may have pertussis before any in-person visits. This will allow them to protect other patients.
Pertussis is usually treated with antibiotics, but it may not eliminate symptoms entirely. A person will not be contagious after five days of medication.
People who may have been in close contact with someone who has pertussis may also be given an antibiotic. This is generally people who live in the same house where there is someone who is under one year of age or pregnant and in their third trimester and any non-household contacts who are under one year of age or are pregnant and in their third trimester.
Isolation and exclusion
Without treatment, a person can stay contagious for three weeks after the start of the cough. Children who are sick with pertussis and taking antibiotics must be kept home from school and childcare settings until they have completed five days of treatment. If they are not treated, they will need to stay home for three weeks from the time symptoms started.
Contacts who are not sick but are receiving antibiotics do not need to be excluded.
It is very important that anyone who is still infectious avoids infants under one year of age and people who are pregnant in their third trimester.
Prevention
The best way to prevent the spread of pertussis is vaccination.
In Ontario, pertussis vaccination is a part of Ontario’s Publicly Funded Routine Immunization Schedule.
The vaccine is publicly funded and is available for free from your health care provider.
- Infants, children, and teenagers should be vaccinated. The vaccine is usually given at 2, 4, 6, and 18 months of age (DTap-IPV-HiB), followed by boosters at 4 to 6 years old (Tdap-IPV) and 14 to 16 years old (Tdap).
- One dose of Tdap vaccine should also be given in every pregnancy to protect the newborn, ideally between 27 and 32 weeks of gestation.
- Adults should also receive a booster (i.e. Tdap) even if they were vaccinated or had pertussis as a child, since immunity can decrease over time.
For more information, contact KFL&A Public Health at 613-549-1232 or 1-800-267-7875.