WHOOPING COUGH

also called pertussis acute, highly communicable respiratory disease characterized in its typical form by paroxysms of coughing followed by a long-drawn inspiration, or whoop, and ending with expulsion of clear, sticky mucus, and often vomiting. The disease was first adequately described in 1578; undoubtedly it had existed for a long time before that. About 100 years later, the name pertussis (Latin: intensive cough) was introduced in England. In 1906 at the Pasteur Institute, the French bacteriologists Jules Bordet and Octave Gengou isolated the bacteria that cause the disease; first called BordetGengou bacilli; later, Hemophilus pertussis; and still later, Bordetella pertussis. After an incubation period of approximately one week, catarrhal symptoms develop, which resemble an ordinary upper respiratory infection, with a short dry cough that is worse at night. After one to two weeks the catarrhal stage passes into the distinctive paroxysmal period, variable in duration but commonly lasting four to six weeks. Serious complications include bronchopneumonia, suffocative attacks, and occasionally convulsions and indications of brain damage. Whooping cough is worldwide in distribution and among the most acute infections of children. A vaccine that confers active immunity against whooping cough to children under six years of age is administered, preferably combined with tetanus and diphtheria toxoids and often with poliomyelitis vaccine as well; immunization is routinely begun during the first three months of infancy. A booster dose of pertussis vaccine should be given at 18 months of age, but not generally thereafter, because reactions to the vaccine may be troublesome in older children. Later vaccinations are in any case thought to be unnecessary, because the disease is much less severe when it occurs in older children, especially if they have been vaccinated in infancy. Treatment includes frequent light feeding to offset the nutritional debility resulting from vomiting; administration of sedatives to induce rest and sleep; and, sometimes, the use of suction apparatus to remove mucus and ease breathing. Antibiotics have little or no effect on the pertussis bacilli but are given to combat secondary infection.