Pertussis (Whooping Cough): When to Go to Emergency
Pertussis (also known as whooping cough) is a highly contagious infection of the respiratory tract. It spreads through droplets when an infected person coughs or sneezes. Because pertussis can be very serious, it’s important to know when to seek medical care.
Risk Factors
Babies and preschool-age children are most at risk. At 2 months of age, most infants in the United States start the vaccination series to prevent pertussis. But the effects of the vaccine fade as children get older, so teens and adults can also get the disease.
When to Go to the Emergency Department (ED)
At first, pertussis may seem like a cold. Your child is likely to have a runny nose, mild fever, and slight cough. After 1 to 2 weeks, the cough tends to become very severe, and coughing spells may last as long as a minute. These produce a “whooping” sound as your child gasps for air. Sometimes, your child may turn red or blue or vomit from the cough. Call your doctor right away if you suspect pertussis. Seek emergency help if your child:
Has a blue color to his or her skin (check fingertips and around mouth). (call 911)
Stops breathing, even for an instant. (Call 911)
Has a high fever within the following ranges:
In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher
In a child 3 to 36 months, a rectal temperature of 102°F (39.0°C) or higher
In a child of any age who has a temperature of 103°F (39.4°C) or higher
A fever that lasts more than 24-hours in a child under 2 years old, or for 3 days in a child 2 years or older
Has had a seizure caused by the fever
Vomits often, or becomes dehydrated.
What to Expect in the ED
A doctor will ask about your child’s symptoms and perform a physical exam. He or she will likely take samples of secretions from your child’s nose or throat. These will be checked in a lab for the bacteria that cause pertussis. Your child also may have blood tests or x-rays.
Treatment
Infants and children with severe pertussis are likely to be admitted to the hospital for treatment with antibiotics and fluids. Milder cases may be treated at home with antibiotics, fluids, and bed rest. Cough and cold medicines are not very helpful and because of the possibility of serious side effects, they should not be used in children under 4 years of age and only in children between 4 and 6 years of age if recommended by your doctor. Never give aspirin to a child under age 18. It could cause a rare but serious condition called Reye's syndrome. Generally ibuprofen is not recommended for infants younger than 6 months.
Prevention
Getting vaccinated is the best way to protect against pertussis. Talk to your healthcare provider about whether your child needs a booster vaccination. Also, be sure to ask whether you need a booster as well.