Pertussis (Whooping Cough) in Adults

What is Pertussis?

Pertussis, or "whooping cough," is a highly contagious disease involving the respiratory tract. It is caused by a bacterium, Bordetella pertussis, which is found in the mouth, nose and throat of an infected person.

Who gets Pertussis?

Pertussis can occur at any age. Severe illness is more common in young children that have not been immunized. Adults with pertussis have milder symptoms. A diagnosis of pertussis should be considered for adults with persistent cough, to ensure they do not pass on the infection.

Currently the main reason for susceptibility to pertussis in adolescents and adults is that immunity has waned since the last pertussis immunization was given before kindergarten. Current immunization recommendations are for children and adults age 11-64 to receive a booster injection against pertussis infections.

How is Pertussis spread?

Pertussis is spread when the infected person coughs or sneezes. The Bordetella pertussis bacterium is spread in droplets.

What are the symptoms of Pertussis?

Pertussis starts as a mild, upper respiratory infection (a cold) - including sneezing, runny nose, fever and occasional cough. Within 10-14 days, the cough becomes more severe. Thick sputum may be present. These symptoms may persist for one to two months, occurring frequently at night. Coughs often come in uncontrollable clusters and may cause vomiting. Adults rarely have the characteristic “whoop” with coughing.

If you have not been immunized, the symptoms are more severe. Check with your provider if you have had a cough that lasts more than two weeks without improvement.

How soon after the infection do symptoms appear?

The incubation period is 7-14 days, but may be as long as three weeks.

When and for how long is a person able to spread Pertussis?

A person can transmit pertussis from seven days following exposure to an infected person, to three weeks after the onset of coughing episodes. Pertussis is only contagious for 5-7 days if antibiotic therapy is begun.

Does past infection with Pertussis make a person immune?

One attack usually provides immunity for many years, but immunity wanes with time. In the case of prior immunization greater than twelve years, occurrence rates over 50% have been reported.

What are the complications associated with Pertussis?

Complications of pertussis may include pneumonia, reactive airway disease, back strain and rib fractures, middle ear infections and dehydration. In infants, seizures, brain damage, and death can occur. Serious complications are rare in adolescents and adults.

Treatment

Antibiotic therapy is the treatment option recommended to decrease the spread of the infection. This will however, not affect the course of the disease. Other supportive options are available. Adequate hydration is important.

References

Cecil's Textbook of Medicine, 21st Ed., 2000. Whooping Cough, pp. 1664-1666
CDC.gov “Emerging infectious Diseases”, Vol. 11, No4, April 2005