Whooping cough

Whooping cough

Whooping cough is a highly infectious childhood disease caused by Bordetella pertussis. It is most severe in young infants who have not yet been immunized.

Clinical presentation

• Paroxysmal cough associated with a whoop

• Fever

• Nasal discharge

Non-pharmacological treatment

• Place the child head down and prone, or on the side, to prevent inhalation of vomitus and to aid expectoration of secretions.

• Care for the airway but avoid, as far as possible, any procedure that could trigger coughing, such as suctioning or throat examination.

• Do not give cough suppressants, sedatives, mucolytic agents, or antihistamines.

• If the child has fever (>38.5°C), give paracetamol.

• Encourage breastfeeding or oral fluids.

Prevention

Whooping cough is preventable by immunization with the pertussis vaccine contained in the DPT-HepB-Hib vaccine at:

• Week 6

• Week 10

• Week 14

Oxygen therapy

• Give oxygen to children who have spells of apnoea, cyanosis, or severe paroxysms of coughing.

• Use nasal prongs and not a nasopharyngeal catheter or nasal catheter, as these can provoke coughing.

Pharmacological treatment

Erythromycin

• Erythromycin (PO) 12.5 mg/kg every 6 hours for 10 days.

If there is fever

Children older than 2 months of age

• Trimethoprim + Sulfamethoxazole (FDC) (PO) 8 mg + 40 mg/kg every 12 hours.