Whooping Cough (Pertussis): Symptoms, Transmission, Complications, and Prevention

Etiology and Transmission

Caused by Bordetella pertussis. Spread via respiratory droplets (cough/sneeze) and fomites. Highly contagious (R₀ ~12–17).

Clinical Stages

1. Catarrhal (1–2 wks): Mild cold-like symptoms; most infectious.
2. Paroxysmal (2–8 wks): Severe coughing fits → inspiratory "whoop," post-tussive vomiting, cyanosis.
3. Convalescent (weeks–months): Gradual resolution.

Complications

• Pneumonia (most common cause of death)
• Seizures, encephalopathy (hypoxia/toxin)
• Apnea (infants)
• Rib fractures, hernias, subconjunctival hemorrhages

Prevention

• DTaP (children) / Tdap (adolescents/adults) vaccination.
• Maternal Tdap in 3rd trimester → passive infant protection.
• Antibiotic prophylaxis for high-risk contacts.

Treatment

Azithromycin (1st line) shortens infectivity if given early; limited effect on paroxysmal phase duration. Supportive care for complications.