Clinical Reference Systems: Pediatric Advisor 10.0

Description

Pertussis is a respiratory infection caused by bacteria called Bordatella pertussis. It is also called whooping cough because of the characteristic sound of the cough it causes.

The illness usually begins with a runny nose, mild cough, and pink eyes that last about a week. Then an increasingly severe cough develops that can last 2 to 4 weeks. The cough usually comes in spasms and ends with a high-pitched whoop. Often the coughing causes a child to vomit or his or her face to turn blue. In infants, whooping cough is a very serious illness and may require them to be hospitalized.

Home Care

1. Antibiotics

   The doctor will prescribe your child an antibiotic.

2. Fever

   Give your child acetaminophen or ibuprofen for fever over 102 degrees F (38.9 degrees C).

3. Coughing spasms

   Warm apple juice or tea may help break the coughing spasms and is soothing to your child. A humidifier in your child's room may also help. (The humidifier must be cleaned every 2 to 3 days.) Gentle suction with a bulb syringe and saline water may be used to get rid of thick secretions in the nose and throat.

4. Fluids

   Encourage your child to drink lots of clear fluids to prevent the mucus in the lungs from becoming sticky.

5. Avoidance of cough triggers

   Keep your children away from things that trigger coughing, such as tobacco smoke, perfumes, or pollutants.

6. Care of exposed persons

   All people in close contact with your child will be asked to take an antibiotic for 14 days. This includes people in your immediate household and any day care contacts your child may have.

Prevention

It is important to have your child and his or her siblings immunized against all preventable illnesses, including whooping cough, at their regularly scheduled health checkups.

Some parents have concerns about the neurologic side effects of the pertussis vaccine. It must be remembered that pertussis is a dangerous disease, especially for infants. The risk of getting pertussis if a child is not immunized is 1 in 3000. The death rate for whooping cough is 1 in 100, and the rate of neurologic problems resulting from whooping cough is 1 in 200. On the other hand, the risk of having neurological damage from the vaccine is reported to be 1 in 2 million. The American Academy of Pediatrics has stated strongly that "the risk of suffering and death caused by whooping cough is far greater than the possible side effects of the vaccine."

Call Your Child's Physician IMMEDIATELY If:

• Coughing spasms cause your child's face, hands, or feet to turn blue.
• Your child stops breathing with any coughing spells.
• Your child's breathing becomes fast or difficult.
• Your child has a seizure.
• Your child is not responding to you or seems lethargic (sluggish).
• Your child is not drinking.
• Your child develops a fever higher than 104 or 105 degrees F (39 degrees C).
• Your child starts to act very sick.

Call Your Child's Physician Within 24 Hours If:

• Your child is less than 6 months old and has coughing spasms.
• Your child has been exposed to someone with whooping cough.
• Your child's cough lasts longer than 3 weeks.
• You have other questions or concerns.