02/17/2025
Day 3 for diseases to be aware of is Bordetella Pertussis (or whooping cough). Unfortunately this disease has never really gone away because of pockets of low vaccine rates (staring at you Oregon). But in addition to whooping cough, it is also known as the “100 day cough” because it lasts so long. It’s also such a bad cough it can cause rib fractures and bleeding around the eyes (subconjunctival hemorrhages). Unfortunately, 2024 set a record of deaths from whooping cough since 2017.
Illness 3: Bordetella Pertussis or whooping cough
Type of infection: Bacteria
Transmissibility: Highly contagious through respiratory droplets
Incubation period: 7-10 days
Clinical Presentation: 3 phases – catarrhal stage with 1-2 weeks of symptoms like a common cold; then the paroxysmal stage with 4 to 6 weeks of severe cough with classic “whoop”. Infants can become apneic and stop breathing during this stage; finally ends with the convalescent stage with a slowly improving cough for another 3 weeks.
Complications: infants with apnea, death, pneumonia, and rib fractures. Can also rarely get cerebral nervous problems from bleeding or anoxia. Historically can cause malnutrition in infants because they cough so much they can’t eat.
Evaluation: CBC with lymphocytosis in infants especially, diagnosis by PCR NAAT
Treatment: macrolide antibiotics
Infection control: isolate contacts, test and treat empirically with macrolide antibiotics regardless of immune status
Prevention: vaccines – DTaP for children under 7, TdaP for children 7 and over. Pregnant women should receive booster of TdaP during 3rd trimester to protect infant for first 2 months. No current recommendation for repeated TdaP for adults (but that may change and I for sure did one before traveling to Oregon last month!!!!)
What whooping cough sounds like:
Listen to a recording of a child suffering from whooping cough, who makes the characteristic 'whoop' sound.Find out the symptoms of whooping cough and how to...
