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Whooping Cough


Disease: Whooping Cough Whooping Cough
Category: Infectious diseases

Disease Definition:

Pertussis, also known as whooping cough, is a highly contagious respiratory tract infection. This cough could eventually turn more serious, especially in infants, even though it initially resembles an ordinary cold. In more advanced stages, it is marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like “whoop”.
Whooping cough is increasing, especially in teenagers whose immunity has faded, and children who are too young to have completed the full course of vaccinations. Although most teenagers and adults recover from whooping cough without complications when treated properly, but it is very serious in children and infants younger than 6 months.

Work Group:

Symptoms, Causes


Usually, it takes about 3 to 12 days for symptoms to appear once a person becomes infected with the bacterium that causes whooping cough. Initially, the symptoms are mild and resemble those of a common cold, such as:


  • Sneezing
  • Dry cough
  • Runny nose
  • Loss of appetite
  • Nasal congestion
  • Mild fever
  • Red and watery eyes
  • General feeling of being unwell


Usually, signs and symptoms become worse after a week or two. They include:


  • Fatigue from the exertion of coughing
  • Sever coughing attacks that bring up thick phlegm
  • Severe coughing in children that usually leads to vomiting or causes a red or blue face from the effort.
  • Coughing attacks, which could go up to 15 coughs in a row, ending with a high-pitched “whoop” sound during the next breath of air.



The signs and symptoms of whooping cough in adults may sometimes resemble those of bronchitis, which is a respiratory infection that causes a nagging cough. Some children may experience choking spells and turn blue in the face because of their struggle to breathe after extended coughing. Infants and babies may not whoop at all, at least not as loud as older children.


Small areas of bleeding in the whites of the eyes can be caused by severe coughing, in addition to tiny red spots caused by ruptures in blood vessels at the skin’s surface (petechiae) in the upper body. Severe episodes of coughing, which could get even worse at night, could cause a bruise or break a rib.


Whooping cough is caused by the Bordetella pertussis bacterium that causes a respiratory infection affecting mostly the windpipe (trachea) and the tubes branching off from the windpipe (bronchi). This bacterium is transmitted through droplets that are coughed or sneezed into the air by someone who’s already infected.


Even though the possibility of spreading the illness remains until the infection is completely cleared, but it is most contagious in the early stages. Once the bacterium gets inside someone’s airways, it multiplies and produces toxins that interfere with the ability of the respiratory to sweep away germs. Uncontrollable coughing is caused by thick mucus that accumulates inside the airways. The breathing tubes in the lungs are narrowed due to the inflammation that this bacterium causes. This narrowing of the breathing tubes leaves a person gasping for air after a fit of coughing.



Usually, adults and teenagers recover from this disease with no complications. However, if complications do occur, they include coughing that could lead to:

  • An abnormal protrusion of a loop of intestine through a weak area of abdominal muscle, a condition known as hernia.
  • A broken or bruised rib.


In the case of children with whooping cough, they could:

  • Develop a hernia
  • Injure the muscles of the chest wall


Complications are more severe in infants suffering from whooping cough, particularly those younger than 6 months. These complications include:

  • Seizures
  • Pneumonia
  • Brain damage
  • Ear infections
  • Dehydration
  • Slowed or even stopped breathing


Complications in infants younger than 6 months could be life-threatening.
Infants and toddlers are more likely to need treatment in a hospital because they are at great risk of complications from whooping cough.


Depending on the patient’s age and severity of signs and symptoms, treatment could vary.



Usually, bed rest and antibiotics, such as erythromycin or azithromycin are prescribed for adults, teenagers and older children in case the whooping cough is diagnosed early. Antibiotics can shorten the duration of the illness and the period of communicability despite the fact that they don’t cure whooping cough. It might be necessary to take antibiotics for at least two weeks or longer if the diagnosis is confirmed but the response to antibiotic therapy is slow. If the illness has progressed to the point of severe coughing spells, antibiotics aren’t as effective but could still be used. Whooping cough usually resolves in six weeks, but it may last longer. Unfortunately, not much is available in the way of symptom relief, and over-the-counter cough medicines have little effect on the illness.



In order to decrease the risk of serious complications associated with whooping cough, almost all infants younger than 3 months as well as older babies are admitted to the hospital. Even though most babies treated for whooping cough overcome the condition without lasting effects, however, the risk of complications exists until the infection clears.


While in the hospital, the child receives intravenous antibiotics to treat the infection and in some cases corticosteroid drugs too, to help reduce airway inflammation. In some cases, the mucus that is blocking a child’s airway could be suctioned. In case extra oxygen is needed, the child’s breathing will be carefully monitored. Intravenous fluids will likely be needed in case the child can’t keep down liquids or food. Prescription sedatives could also help the child rest. To keep the infection from spreading, the child should be isolated from others.


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Consultants Corner

Yaser Habrawi , F.R.C.S.Ed

Yaser Habrawi , F.R.C.S.Ed Consultant Ophthalmologist

Dr. Talal Sabouni


Dr. Hani Najjar

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Dr. Tahsin Martini

Dr. Tahsin Martini Degree status: M.D. in Ophthalmology

Dr . Dirar Abboud

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Dr. Faisal Dibsi

Dr. Faisal Dibsi Specialist of Otolaryngology - Head and Neck Surgery

Samir Moussa M.D.

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Dr. Samer Al-Jneidy

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