Pertussis Definition

An illness resulting from infection with the virus Bordetella pertussis. Pertussis is among the childhood diseases for which routine immunization is the standard of care in the United States. The hallmark of the illness is a rapid, violent cough that causes the person to make a “whooping” sound when trying to breathe through the coughing, hence the common term whooping cough.

The cough can be severe enough to prevent breathing. Pertussis was once a leading cause of death among children under age 5. Though immunization has dramatically reduced infection, pertussis may still be fatal in very young children and very old adults. Immunity, either natural (following infection and illness) or via vaccine, lasts about 12 years.

Symptoms of Pertussis

The unmistakable cough is the primary symptom and begins about seven days after exposure. In untreated pertussis, the cough worsens rapidly and may continue for as long as eight weeks. Many people also experience vomiting with the coughing.

The doctor often makes the diagnosis on the basis of the cough, though cultures taken from the mouth and nose may provide confirmation. Cultures are positive in about 80 percent of people.

Pertussis Treatment

Treatment in the early stages of pertussis is antibiotic medications, typically erythromycin or trimethoprim and sulfamethoxazole (TMP-SMZ). The further into the course of illness, the less effective antibiotics become, however. The infection causes the nasal passages, throat, bronchi, and bronchioles to ooze fluid that clogs the airways; the cough is the body’s attempt to remove the fluid to permit free breathing.

A profusely runny nose (rhinorrhea) is the earliest symptom of pertussis though often is perceived as a cold until the cough begins. Antibiotic therapy can substantially shorten the course and lessen the severity of illness. Most people recover fully with appropriate treatment, particularly when treatment begins early.

See also CHILDHOOD DISEASES; DIPHTHERIA; PREVENTIVE HEALTH CARE AND IMMUNIZATION.

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