Pertussis
Introduction:
Pertussis,
also known as whooping cough, is a very contagious bacterial infection
of the respiratory tract. It is characterized by violent coughing,
followed by a "whoop" sound as the person tries to breathe in.
Pertussis
can be deadly to infants and small children. Children in the U.S. are
routinely vaccinated for pertussis, but the disease is rising again,
especially in infants who have not completed the series of vaccinations
and in teens whose immunity has worn off. Babies need a series of three
vaccines before they are fully protected. The vaccine keeps children
from getting the disease when they are most at risk, but immunity
weakens as we get older and teens and adults who have been vaccinated
can still get a milder form of the disease. The American Academy of
Pediatrics recommends that children between 11 and 18 get a booster shot
that includes a whooping cough vaccine.
Signs and Symptoms:
There are three stages of the disease.
Stage one (lasts 1 - 2 weeks):
- Upper respiratory infection. Can be mistaken for the common cold
- Slight fever (less than 100.4° F)
- Loss of appetite
- Very runny nose
- Sneezing
- Mild, occasional cough
Stage two (lasts 1 - 6 weeks):
- Cough gets worse (2 - 50 times a day) and coughing spells last longer
- Cough may end with a “whooping†sound as the person tries to draw a breath (however, not all people have the “whoop†sound)
- Sudden intense bouts of coughing (paroxysms) can cause bulging and tearing eyes, tongue sticking out, and bluish discoloration
- Vomiting or choking may follow coughing bouts
- Pneumonia may develop
Stage three (lasts 2 weeks to several months):
- Cough slowly goes away away
What Causes It?:
Whooping cough is caused by a bacteria called Bordetella pertussis.
It is spread through droplets coughed or sneezed into the air. It is a
highly contagious disease. Adults with a mild form can infect people who
have not yet been vaccinated.
What to Expect at Your Provider's Office:
Sometimes
your doctor can diagnose whooping cough by listening to your cough. But
whooping cough can be hard to diagnose in the early stages. Your health
care provider may take a smear from your nose or throat, and ask you to
avoid contact with others while you are contagious. People with
complications, severe coughing bouts, or who are under two years of age
are hospitalized.
Treatment Options:
Whooping
cough can be deadly to a baby under 6 months of age, and can cause
complications even in toddlers. A baby with pertussis should be treated
immediately by a doctor. In adults, treatment is largely to control
symptoms and prevent spreading. Quarantine, IV fluids and nutrition,
oxygen, and a ventilator may be needed in some cases.
Drug Therapies
- Antibiotics -- reduce transmission and shorten the duration of the illness. Azithromycin (Zithromax) or erythromycin are often prescribed.
- Corticosteroids such as betamethasone (0.075 mg daily per kilogram of body weight) -- may reduce severity and length of coughing fits, especially in infants.
- Albuterol (0.3 - 0.5 mg daily per kilogram of body weight) -- reduces the severity of coughing fits.
Over-the-counter cough suppressants have no effect and should not be used, especially in children under 2.
Surgical and Other Procedures
Suctioning of secretions, oxygen, IV fluids, and electrolytes are used for infants and adults at risk for longer illness.
Mist by tent may help infants.
Complementary and Alternative Therapies
Pertussis
should be treated with antibiotics. Do not rely on herbs and
supplements alone, especially for children. Supplements, herbs, and
homeopathy may help you recover faster when used along with conventional
medications. Always talk with your doctor if you are using alternative
therapies in addition to medication.
Nutrition
Note: Doses given are for children. Adults should double the amounts.
Give small, frequent meals of vegetable broths, steamed vegetables, and fresh fruit (especially pineapple and grapes).
Vitamin
C (200 - 500 mg two times per day. Children over 4 can have up to 3,000
mg per day in divided doses for short periods of time), zinc (10 - 15
mg per day), and beta-carotene (10,000 - 25,000 IU per day). Be sure to
use beta-carotene and not vitamin A. Ask your doctor before giving
vitamin supplements to a child.
Herbs
Herbs
are generally a safe way to strengthen and tone the body's systems. As
with any therapy, you should work with your health care provider to
diagnose your problem before starting any treatment. You may use herbs
as dried extracts (capsules, powders, teas), glycerites (glycerine
extracts), or tinctures (alcohol extracts). Unless otherwise indicated,
make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10
minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4
cups per day. You may use tinctures alone or in combination as noted.
Pertussis
should be treated with antibiotics. Do not rely on herbs alone,
especially to treat a child. Do not give herbs to a child without first
checking with your pediatrician.
No
studies have looked at whether herbs can help specifically with
whooping cough, but these herbs have been used traditionally to treat
coughs and strengthen the immune system.
Catarrhal
stage: Choose two herbs from each of the first two categories. Combine
in equal parts in a tea (½ cup every 3 - 4 hours), a tincture or
glycerite (30 drops every 3 - 4 hours).
Paroxysmal
stage: In addition to the above formula, combine 2 parts of catnip with
two to four of the other antispasmodic herbs in a tincture or glycerite
(20 drops every 1 - 2 hours).
Immune-stimulating herbs:
- Coneflower (Echinacea purpurea)
- Usnea lichen (Usnea spp.)
- Garlic (Allium sativum)
- Astragalus (Astragalus membranaceus)
Expectorants:
- Hyssop (Hyssopus officinalis)
- Anise (Pimpinella anisum)
- Elecampane (Inula helenium)
- Mullein (Verbascum densiflorum)
Antispasmodics:
- Indian tobacco (Lobelia inflata) (not more than 1/4 of combination)
- Catnip (Nepeta cataria)
- Chamomile (Matricaria recutita)
- Jamaican dogwood (Piscidia erythrina)
- Thyme (Thymus vulgaris)
Homeopathy
Although
very few studies have examined the effectiveness of specific
homeopathic therapies, professional homeopaths may consider the
following remedies as supplemental treatment for the symptoms of
pertussis as long as the underlying infection has been appropriately
treated. Before prescribing a remedy, homeopaths take into account a
person's constitutional type -- your physical, emotional, and
psychological makeup. An experienced homeopath assesses all of these
factors when determining the most appropriate treatment for each
individual.
- Aconite -- Take during the first 24 hours after symptoms appear, particularly if they develop following exposure to cold weather. This remedy is most appropriate for individuals with a hoarse, dry, cough who complain of dry mouth, thirst, restlessness, worsened symptoms from cold air or lying on the side, and being awakened from the cough.
- Bryonia -- for painful cough with a marked tendency to hold their chest or hold something to the chest when coughing.
- Drosera -- for dry, spasmodic cough with sharp chest pain and a tickling sensation in the throat that may cause the individual to gag, choke, or vomit. This remedy is most appropriate for individuals who tend to be hoarse, become worse when lying down, and perspire during the night.
- Hepar sulphuricum -- for later stages of pertussis with wheezing, little mucus production, and coughing that comes on when any part of the body gets cold.
- Ipecacuanha -- spasmodic cough and gagging or vomiting. This remedy is commonly prescribed for infants.
- Phosphorus -- for several different types of cough, most particularly a dry, harsh cough described as a persistent tickle with sharp chest pain signified by the individual clutching his or her painful chest. This remedy is most appropriate for individuals who are often worn out and exhausted, have undue anxiety, even fear of death, and require a lot of reassurance.
- Spongia -- for harsh, barking cough that produces no mucus and is associated with a tickling in the throat or chest that worsens when lying down and improves when the individual eats or drinks warm liquids. This remedy is often used when Aconite is unsuccessful.
Physical Medicine
Chest
rubs -- Use 3 - 6 drops of essential oil (camphor, thyme, eucalyptus,
rosemary) with 1 Tbs. food-grade oil (almond, flax, or olive). Avoid
getting essential oils in the eyes. Make sure the mixture is not too
strong, as it could irritate the respiratory tract. Do not give
essential oils by mouth (internally).
Castor
oil pack -- Apply oil to clean soft cloth, place on chest, and cover
with plastic wrap. Place a heat source over the pack, and let sit for 30
- 60 minutes. Do not use for more than four days in a row. Do not give
castor oil by mouth (internally).
Place 3 - 6 drops of essential oil in a humidifier or a warm bath.
Alternate hot and cold applications to the chest or back. Alternate 3 minutes hot with 1 minute cold.
Acupuncture
Although
acupuncture has not been studied for whooping cough, some people may
use acupuncture to help strengthen the immune system.
Massage
Foot massage can be relaxing and may help a child sleep. Some children may not want to be touched, however.
Following Up:
Most adults and children make a complete recovery.
Special Considerations:
Vaccinations are 80 - 90% effective. They last about 12 years.
Alternative Names:
Cough - whooping; Whooping cough
- Reviewed last on: 3/13/2010
- Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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