Whooping cough (pertussis) is an acute infection of the upper respiratory tract. Typical symptoms are spasmodic coughing fits and a wheezing noise when breathing afterwards. Whooping cough affects children and adults alike, but manifests itself somewhat differently. Read here how contagious whooping cough is, how it is treated and why it often goes undetected, especially Whooping cough in adults.
Whooping cough is a highly contagious condition. An infection that is far more common in infants, although people of all ages can get it. Symptoms of whooping cough tend to be less severe in adults than in children, with unvaccinated infants having the greatest risk of suffering serious harm from this infection, in addition to the more common complications from whooping cough.
In this study, however, we will try to deal with the symptoms and complications of whooping cough in adults, then focusing on the main treatment options that, obviously, we recommend that you share with your referring doctor.
ICD codes for whooping cough disease: A37
- Symptoms: Barking, staccato cough, wheezing when breathing after attacks, less typical symptoms in adults
- Course of the disease and prognosis: Symptoms often last for several weeks, and whooping cough usually heals without consequences. Complications are possible, with babies severe and life-threatening courses are possible
- Causes and risk factors: Bacterial infection with Bordetella pertussis, more rarely related bacterial strains. Transmission by droplet infection, unvaccinated people almost always fall ill after contact with the pathogen
- Treatment: antibiotics, inhale, drink enough, rest; inpatient treatment of high-risk patients such as infants
- Examinations and diagnosis: Physical examination, depending on the stage of the disease, detection of pathogens, smear test, bacterial culture, PCR detection, detection of antibodies in the blood
- Prevention: whooping cough vaccination.
What is whooping cough?
Many are familiar with the term, but are wondering: whooping cough or pertussis – what is that actually?
Whooping cough is a contagious, bacterial infectious disease. The main pathogen is called Bordetella pertussis. Babies and children are often infected with whooping cough, but it is also possible for adolescents and adults to become infected, especially if they have not been vaccinated or the vaccination protection has decreased.
Whooping cough is very contagious. Transmission usually takes place via droplet infection. The triggering bacteria form a poison (bacterial toxin) in the course of the infection, which damages the mucous membranes of the respiratory tract. The toxin continues to be harmful even when there are no more bordeaux in the body.
Whooping cough in adults
Whooping cough was long considered a “childhood disease”. However, this is not the case. Increasingly, adolescents and adults are also affected by:
In 2008, the average age of whooping cough patients was around 42 years. 10 years ago it was still around 15 years. Two-thirds of all whooping cough cases now affect people over the age of 19.
This is because adults often forget to take the necessary booster shots : almost all children are vaccinated against whooping cough when they start school.
However, vaccination does not provide lifelong immunity and needs to be boosted. If you don’t do this, you risk contracting whooping cough if you come into contact with it.
Symptoms of whooping cough in adults
As we have already anticipated, whooping cough can affect adults and often occurs less severely than it does in children.
Adults therefore tend to experience less severe symptoms of pertussis than younger people, and for a very clear reason: adults have accumulated immunity from previous infections and vaccinations, and therefore their bodies are more “ready” to cope with this attack.
Also keep in mind that the bacteria that cause whooping cough are those called Bordetella, which are spread through the air when someone who is infected with whooping cough sneezes. Symptoms usually develop 5 to 10 days after exposure, but some people may not develop symptoms for several weeks.
Whooping cough develops in three stages
In the first stage, people are highly contagious. At first, whooping cough causes mild cold-like symptoms, lasting 1 to 2 weeks, such as runny nose, sneezing, mild fever, fatigue, mild cough.
In the second stage, people may develop a severe, persistent cough that leaves them wheezing. The classic wheezing occurs when people abruptly inhale air to catch their breath after a cough. People are still contagious at this point in the disease’s evolution, with symptoms lasting anywhere from 1 to 6 weeks.
We then enter the third phase. Here the cough gradually improves and coughing attacks are less frequent. At this point, people are no longer contagious, but they run the risk of developing other infections that can slow down the recovery process.
Whooping cough in adults
Whooping cough in adults often takes an atypical course : the symptoms are milder, the coughing fits are less severe and continuous rather than attack-like. The risk of suffocation is low.
However, this does not make the infection any less dangerous, on the contrary: many sick adults simply consider whooping cough to be a particularly persistent but common cough. As a result, they often do not go to the doctor.
Without treatment, however, there is a risk that whooping cough pathogens will spread throughout the body. In rare cases, this leads to complications and secondary diseases. These include, for example, pneumonia or middle ear infections and broken ribs as a result of whooping cough.
Adults who develop pertussis are also often a danger to others. They are considered a serious source of infection for infants and the elderly. In these groups of people, whooping cough is sometimes difficult.
How does whooping cough progress?
Whooping cough sometimes lasts for weeks to months. The disease is relatively mild in some patients, but severe in others. As a rule, however, pertussis heals completely without any lasting long-term effects.
About every fourth whooping cough patient develops complications. These include pneumonia and otitis media. Children are affected more often than adults.
Whooping cough is particularly dangerous for infants under the age of six months. In extreme cases, the breathing pauses cause a significant lack of oxygen, which damages the brain. Possible consequential damages are permanent paralysis, visual or hearing disorders as well as mental disorders.
Death from whooping cough in babies is possible, but very rare. To ensure that infants with whooping cough are closely monitored medically, hospital treatment is recommended.
What is the cause of whooping cough?
Whooping cough is caused by the bacterium Bordetella pertussis. It affects the nose, throat, trachea and lungs and irritates the mucous membranes. This triggers the spasmodic coughing fits.
The bacterium also secretes various poisons (toxins). These damage the surrounding tissue, especially the cilia of the mucous membranes in the airways.
In addition, they weaken the local defense. This makes it easier for the germs to multiply.
If left untreated, whooping cough can cause serious complications. In newborns, pertussis is sometimes life-threatening.
In whooping cough, bacteria enter the upper respiratory tract via microdroplets. They destroy the mucous membrane and thus trigger spasmodic coughing fits.
In addition to Bordetella pertussis, there are rarely other related Bordetella species, such as Bordetella parapertussis and Bordetella holmesii. In most cases, however, an infection with these pathogens is shorter and less severe.
The diagnosis of whooping cough in adults
A doctor can diagnose whooping cough by examining the patient’s medical history and a person’s current symptoms.
However, it sometimes happens that doctors are misleading to diagnose whooping cough as a common cold or another respiratory infection, because whooping cough in adults does not typically cause severe symptoms.
In order to clarify the suspicion of whooping cough, the doctor will first collect the medical history of the patient. He talks to the patient or – in the case of small children – to the parents about the symptoms that are occurring. Typical questions are:
- How long has the cough been there?
- Is mucus coughed up or is the cough rather dry?
- Do you have problems breathing after the coughing attacks?
- Do you have any other symptoms (fever, sore throat, chest pains, etc.)?
The doctor will also examine the patient physically. This includes tapping the chest and listening to the lungs. He also takes a look down the throat. If he presses his tongue with the spatula, he triggers the characteristic coughing fits in whooping cough.
If the typical whooping cough symptoms (in children) are present, this makes the diagnosis easier. Laboratory tests are performed to confirm. Some blood values are sometimes increased in whooping cough, such as the number of white blood cells. This indicates inflammation but is not specific to whooping cough.
Laboratory tests are particularly important if whooping cough is atypical. This is particularly common in infants, but also in adolescents and adults. The latter now represent the most common age group among whooping cough patients.
Laboratory tests and whooping cough tests
The type of laboratory tests used depends on the stage of the disease.
In the first two to three weeks after the onset of coughing, an attempt is made to detect the whooping cough pathogen directly. To do this, the doctor either takes a swab from the deep throat or sucks out some bronchial mucus, which is transported upwards when you cough.
The laboratory uses the sample to create a bacterial culture and determines which germs have grown. Alternatively, the genome of the bacteria contained in the sample can be amplified using polymerase chain reaction (PCR) and then identified. It is also possible to prove whooping cough pathogens.
Another possibility is the so-called serum diagnostics. The patient’s blood serum is examined for antibodies against the whooping cough pathogen. This method is only possible in advanced stages of the disease: such specific antibodies can only be detected about three weeks after the onset of coughing.
If an adult is experiencing a persistent cough, the doctor who suspects the cause of the condition may recommend further medical tests, and correctly diagnose the problem. These tests may include a nasopharyngeal swab – a doctor collects a sample of mucus through the nose to test for B bacteria.
The complications of whooping cough
Whooping cough can make sleeping quite difficult. However, adults can develop secondary complications and much more serious discomfort: a violent cough can cause fainting or fractured ribs, for example. Other potential complications of whooping cough in adults include:
- Difficulty falling or staying asleep, called insomnia,
- Difficulty breathing during sleep, called sleep apnea,
- Accidental weight loss,
- Eye infections.
Treatment of whooping cough in adults
Let us now turn to the treatment of whooping cough in adults, that is its treatment which, like every other aspect of this study, we naturally recommend that you share with your referring doctor.
In general, treatment depends on the duration of the disease and the severity of the symptoms. Treatment of whooping cough usually involves antibiotic therapy, and if done early it can actually reduce the severity of symptoms, speed up recovery times, and prevent people from passing the bacteria on to other people. The doctor may therefore also want to prescribe antibiotics for other family members who have come into close contact with the patient.
We also remember how according to doctors, antibacterial treatments are most effective during the first 2-3 weeks of infection or before the onset of coughing attacks. However, people rarely get treatment early enough to experience these benefits, complicating the healing journey.
There are also some tips and “home” remedies that can aid healing from whooping cough, such as:
- Stay hydrated
- To rest
- Practice proper hand hygiene
- Eat small meals often rather than a few large meals
- Avoid cough triggers, such as smoking, strong chemicals, and allergens.
As with other diseases, the following applies to pertussis: The therapy and healing process for whooping cough depend on the stage and severity of the disease.
Whooping cough therapy in adults
Treatment for whooping cough in adults is similar to that in children. Antibiotics are preferably given in the early stages of the disease. In later stages, they serve to reduce the risk of infection for other people, especially infants. For them, whooping cough is sometimes life-threatening.
Inhalations, chest wraps, sufficient fluid intake and humidified room air also support whooping cough treatment.
Employees of community facilities (such as teachers, educators, nursing staff, etc.) are only allowed to go back to work if the treating doctor allows it. On the basis of examination and laboratory findings, he assesses whether the patient is still excreting whooping cough pathogens or not.
We remind you that whooping cough does not respond to traditional cough medicines, and therefore we should not take over-the-counter, do-it-yourself drugs, in the hope that they can be of relief. Finally, we highlight how recovery from whooping cough can take several weeks, and whooping cough can still continue to leave some aftermath for a few months.
Whooping Cough Vaccination
A vaccine is available to protect against whooping cough. The whooping cough vaccination is recommended in early childhood and is possible from the second month of life. Regular booster shots maintain immunization protection against whooping cough, even in adulthood.
The following groups of people in particular are recommended to be vaccinated against whooping cough:
- Women of childbearing age
- Close contact persons of pregnant women in the same household and caregivers (e.g. childminders, parents, siblings) four weeks before the birth of the child if possible
- Caring parents of a child with whooping cough
- Employees in the health service and in community facilities
Risk of infection and incubation period
Whooping cough is highly contagious. Most people who come into contact with the pertussis pathogen fall ill without vaccination protection. Whooping cough is transmitted via droplet infection : When infected people speak, cough or sneeze, tiny droplets spread around them in a radius of up to one meter.
These small droplets contain whooping cough bacteria. If they get on the mucous membrane of a healthy person (e.g. through inhalation), they become infected.
You can also get whooping cough from kissing. This also applies if you use the same cutlery or drinking vessel as a sick person.
Even if you have been vaccinated against whooping cough and do not get sick yourself, there is a risk that you will become a carrier of the bacteria for a short time. In this way, you pass the germs on to other people unnoticed.
As with most infectious diseases, it takes a certain amount of time for whooping cough to show the first symptoms of pertussis after infection. This so-called incubation period for whooping cough is about 7 to 20 days.
Those affected are contagious from the onset of the first symptoms (common cold phase) and then for another five to six weeks. Exception: Treatment with antibiotics shortens the contagion phase. A patient is no longer contagious five days after the start of therapy.
The best way to protect yourself from whooping cough is to avoid contact with people who are sick. In the case of illnesses in the family, it is advisable to observe careful hygiene.
Whooping cough is highly contagious, and whooping cough vaccinations wear out with advancing age. Adults who have not received the booster vaccine for whooping cough have a higher risk of getting this infection.
Other factors that increase the risk of getting whooping cough include:
- Being in close contact with someone who has whooping cough
- Have a weakened immune system
To find out more, we recommend that you talk to your family doctor and understand how to cope with any evolution of the disease.