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Articles : A to Z Conditions (including Pertussis)
  
Pertussis (Whooping Cough): Back to Articles
by Lauren Feder, M.D.

 Excerpt from Dr. Feder's,  The Parents' Concise Guide to Childhood Vaccinations

What is whooping cough?

Pertussis (whooping cough) is a contagious illness caused by the Bordatella pertussis bacterium. In the United States it used to be a common childhood illness known as the 100-day cough named after the characteristic “whoop” sound heard during cough attacks. The bacteria spreads easily from contact with an infected child or adult in the first 2-3 weeks of the infection, usually before the illness is properly diagnosed.

 

The incubation period is commonly 7-10 days, with a range from 6-21 days. Like many illnesses, pertussis starts with a cold-like stage (the most contagious phase) that of familiar symptoms such as runny nose, sneezing, low-grade fever, and mild cough.  Within one to two weeks, the child begins to experience worsening of the cough. These develop into attacks or coughing spells that come in fits of  rapid coughs followed by the characteristic long inspiration with a crowing sound or high-pitched whoop, from which it earns its name.  Choking, gagging or vomiting while coughing may be triggered from the thick mucus build up in the lungs.  In more severe cases a child may turn blue in the face, also known as cyanosis.  Although the child may be exhausted immediately following a coughing spell, he often appears and acts normal.in between coughing fits.  

 

Having whooping cough does not provide life long immunity. Adolescents and adults who have previously had the infection in childhood may have milder forms of whooping cough which may go undetected and diagnosed as a bronchitis or a simple cough.  From beginning to end, the stages of whooping cough can last 2-3 months earning the name the 100-day cough.

 

Complications of Pertussis

The most common complication associated with whooping cough is pneumonia.  Although the bacteria can lead to ear infections, dehydration, convulsions, and, in rare instances, brain damage or death.  Pertussis poses a greatest risk to infants and small children due to the small size of their air passages. For this reason, they are at the highest risk for pertussis and its complications compared to older children and adults.

 

How Common is Whooping Cough?

The Center for Disease Control (CDC) reports that the incidence of whooping cough has decreased 98% since the inception of the vaccine.  In the holistic medical community, it is generally felt that pertussis is less severe now than in the past due to improvements in sanitation, nutrition, and education, and because of more sophisticated medical treatments for complications.  In the United States, approximately 10,000 cases were reported in 2003, with outbreaks occurring every three to four years.  Approximately half of whooping cough cases occur in children less than five years old; thirteen children died of pertussis in the United States in 2003.   Pertussis can account for nearly 7% of all adult coughs. 

 

The rate of pertussis, however, has increased steadily since the 1980s.  It is estimated that only one third of pertussis cases in the US are actually reported.  Overall, adolescents and adults have seen increases in whooping cough, most likely attributable to their immunity waning in the years following the vaccine.

 

Whooping Cough Vaccine

The pertussis vaccine is given as a part of the DTaP (diphtheria, tetanus, and acellular pertussis) series beginning at two months of age.   There are five doses given at two months, four months, six months, fifteen to eighteen months, and four to six years old. The severe complications caused by the original whole-cell pertussis vaccine led to the development of acellular vaccines (acellular pertussis ‘aP’ ), while the publicity surrounding the original pertussis vaccine complications is to a large extent responsible for the current public awareness about vaccine injuries. 

 

Vaccine Reactions

Complications to the vaccine are well documented and include local swelling, fever, high-pitched screaming, convulsions, mental retardation, disabilities, and death. Reactions to acellular form of the pertussis vaccine are milder compared to the whole-cell vaccine; however, severe reactions to the acellular vaccine also occur, including encephalitis and death.   The pertussis vaccine is only given to children less than seven years of age as it can cause severe reactions over the age of seven.

 

DTaP causes serious complications in less than 1% of injections. These complications include:

·fever greater than 105 degrees F (30 in 10,000 doses)

·non-stop crying (<1 in 100 doses)

·seizure (6 in 10,000 doses)

·an episode where the child becomes limp, pale, and less alert (6 in 10,000 doses)

Protection lasts approximately 5-10 years.  Whooping cough is now more common in adults than in the past because they did not have whooping cough in childhood and did not develop permanent immunity.

 

The pertussis vaccine should not be given to children who have a history of convulsions, brain disorder, or abnormal development.  Some of my families have refused the pertussis shot if there is a family history of seizures.

 

Treatment for whooping cough

See your pediatrician if you suspect your child has whooping cough. It will usually last approximately six weeks no matter the treatment. Because Pertussis is contagious, avoid contact with others.

 

Standard treatment includes the general support of rest and liquids.  Your doctor will prescribe an antibiotic such as erythromycin or zithromax as it is felt that the antibiotic renders your child less contagious. While it remains questionable whether the antibiotic changes the course of the illness, people are generally no longer considered contagious after the fifth day on antibiotics.

 

See your healthcare provider if you suspect you or your child has whooping cough.  

 

Treatment for Pertussis

When I treat a child for pertussis, I am reminded that it is by no means an ordinary cough. With standard coughs and colds, we expect that the child will be better in a few days, but whooping cough is a serious infection and follows a different course. A well chosen remedy can help shorten the course of illness, decrease the severity of the cough, and make the child more comfortable.  The following are some commonly used remedies for whooping cough and strong coughs in general.  There need not be a confirmed diagnosis of pertussis in order to use the following remedies.

 

Rattling cough– Antimonium tartaricum

Antimonium tartaricum is used for rattling in the chest with a strong loose cough.  The chest feels full of mucus, yet the child is too weak to bring up the phlegm (this is not unusual in young children).   The child tends to bend backward while coughing and is sleepy after a coughing fit.  There can be shortness of breath, sense of suffocation, and the child feels better sitting up to breathe.  The cough can end in vomiting.  The child is irritable, whiney, prefers to be left alone.

 

Winter cough with ropey mucus—Coccus cacti

Coccus cacti is a pertussis remedy especially noted for winter coughs.  The child might have a tickling in the throat, and feels better in the cold open air and drinking cold liquids.  The mucus is clear, thick, and ropey, and may hang out of the mouth. The strong fits of coughing can end in choking and vomiting.  Coughing spells are common from 6-7 a.m. and after 11:30 p.m.

 

Cramps and spasms - Cuprum

Cuprum metallicum (Cuprum) is indicated for violent coughing fits that cause a child to turn blue in the face (cyanosis).  In general, Cuprum is strongly indicated for spasms and cramps occurring in the calf muscles, hands, abdomen, and throughout the body.  Coughs may be so strong that the child can suffer a seizure, and may also be accompanied by a rattling in the chest. The child desires cold drinks and to lie down.

 

Violent, choking - Drosera

Drosera is another remedy for violent coughing spells ending in

choking, gagging, or vomiting.  In these instances, the cough is so strong that the child can hardly catch her breath. Often the child is worse when first lying down, and after midnight.  She is better in the open air. Drosera is also indicated for barking coughs and croup.  Dryness and tickling in the throat trigger the cough. Bloody nose and a hoarse voice are common.

 

Nausea and vomiting with cough - Ipecacuanha

Ipecacuanha is made from ipecac, which is used to induce vomiting. Prepared homeopathically, this remedy is good for whooping cough and other severe suffocative coughs that end in retching, vomiting, or cyanosis with stiffness in the body.  The child feels nauseated and has an aversion to food (including the smell of food). There is rattling in the chest with constriction in the throat before the cough. The child may also have bloody nose with the cough. The cough is worse at 7 in the evening and better in the fresh air.

 

Dry and painful - Bryonia

Bryonia alba (Bryonia) is an excellent cough remedy for a cough that is dry, racking, painful in the chest and head, and made worse from motion and better from being still.  The child often holds her chest while coughing since any movement is painful.  Taking a deep breath triggers the cough.   This cough is worse from eating and drinking, and often grows worse at 9 p.m.  The child’s mood is irritable, “like a bear,” and she or he has a strong thirst for cold drinks.

 

After exposure - Pertussin

Homeopaths have been treating whooping cough with pertussin homeopathic remedy since the 1800s.  It can be used to treat whooping cough (and other severe coughs) or can work as a preventive.  Pertussin is administered when the cough is dry, choking, and hacking, and triggered by a tickle in the throat or chest. The cough is deep sounding and croupy, and the face flushes after a coughing spell. There may be sighing at the end of an attack.  Pertussin 30C can be used once a week as an immune strengthener during whooping cough outbreaks.  


Gemmotherapy

The following is a list of common gemmos I use for severe coughs like pertussis.

 

Lithy Tree (Viburnum lantana) targets the lungs and restores pulmonary function. Lithy Tree is helpful for severe coughs, bronchial spasm, and bronchitis.

 

European Hornbeam (Carpinus betula) is indicated when there is an abundance of mucus.  Well known as a sinus remedy, it is excellent for infections of the ear, nose, throat, and chest, as well as for spasmodic coughs and bronchitis.

 

Briar Rose strengthens a child's immune system and is useful for conditions involving ear, nose, throat, sinuses and chest. I use this as a preventative 2-3 times a week as needed during cold and flu season. During an illness, use twice a day.

 

Lemon Bark (Citrus limonum) is used in conjunction for spasmodic coughs.  It is also an excellent remedy for hiccups and headaches, including certain migraines.

 

When to call the doctor

If you suspect that your child has a serious infection like whooping cough, consult your doctor.  Severe coughs can lead to dehydration, exhaustion, and difficulty breathing, which can be life threatening.

 

 

 
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