When Whooping Cough Returns

Whooping cough is also known as pertussis, which is the P in the DPT (diphtheria, pertussis, tetanus) vaccine given to children.  Whooping cough is another illness that begins like a normal cold, with a fever (usually, but not always), runny nose, and cough.[1]  The whooping begins about two weeks later, where the child coughs repeatedly without breathing, until a plug of mucus is expelled, and the air rushes back into the lungs with a very audible whoop.  While coughing, the lips and nails may turn blue due to the lack of oxygen, and after the whoop the child may vomit.  Whooping cough can last more than 3 months (it’s known as the “100-day cough” in China) and is particularly dangerous in infants under 12 months of age.[2]

What’s unique about whooping cough is that the microbe attaches to the mucosa of the upper respiratory tract.  The bacteria (Bordetella pertussis) release toxins which cause the swelling.  The toxin injures the cells lining the respiratory tract, and it takes up to 3 months for the cells to be repaired or replaced.[3]

Young infants do not develop the typical whoop so it can be difficult to determine whether they have whooping cough.  If a baby gets fits of coughing and swollen or puffy eyes when there are cases of whooping cough in the area, treat for whooping cough immediately.[4]

Because there is so much coughing that patients become totally exhausted, adults and teenagers afflicted with whooping cough can become quite sick, but usually do not die.  Currently, in children under 12 months of age admitted to a hospital with modern technology, the mortality rate is 1.5%.  Twenty percent will also develop pneumonia.  Furthermore, some will develop a brain injury and possibly die due to the constant coughing.[5]

The following information comes from The Ship’s Medicine Chest and Medical Aid at Sea.

Incubation Period:  7 to 14 days.

Isolation Period:  4 weeks after the “whoop” begins.

Whooping cough is a highly communicable bacterial disease of early childhood that is caused by the bacillus Bordetella pertussis. Although it is unlikely to occur among the crew, it should be suspected if the patient had been exposed to a case of whooping cough one to three weeks previously, develops a cold with a cough, the coughing causes vomiting, and the typical “whoop” develops.  The disease is spread by the patient’s coughing, sneezing, and through contact with anything he has touched. 

The disease often starts like an ordinary cold with runny nose, sneezing, and coughing.  Usually there is no fever.  Then listlessness shows with a loss of appetite and a persistent hacking cough that occurs at night but gradually includes the daytime as well.  This catarrhal stage lasts about two weeks.  In the next stage the patient will exhibit chilling and a thick mucus forms in the respiratory tract with increased coughing in spasms.  There will be coughing spells 6 to 12 or more times in rapid succession all in one breath.  This forces air from the patient’s lungs and his face turns bluish from the extreme effort and the lack of air.  The patient catches his breath in a long noisy deep inhalation (the whoop).  During these coughing spasms much mucus is brought up but the irritation continues.  The combined coughing and gagging often leads to vomiting.

The characteristic whooping type of cough reaches its worst stage about two or three weeks after symptoms begin.  Then the convalescent stage occurs when coughing reduces in frequency and severity and vomiting decreases. 

Treatment

No specific treatment for whooping cough is known.  Medical advice by radio should be obtained, especially on the repeated dosage of codeine sulfate described below.

The patient should be isolated.  This will protect others from the disease and there will be less likelihood for the patient to develop serious complications as pneumonia, middle ear infection, chronic bronchitis, or encephalitis, among others.  There always is the threat of suffocation, plus inhalation of vomitus while coughing.  Use of suction may be lifesaving.

Antibiotic therapy has not been proven to be beneficial in uncomplicated whooping cough.  Treatment should be symptomatic, with aspirin 600 mg and/or codeine sulfate 30 mg given by mouth every six hours, if needed.  If aspirin is not well tolerated by the patient, acetaminophen may be tried at the same dosage.  Phenobarbital 30 mg may be given every eight hours by mouth, if mild sedation is warranted.  Between periods of nausea, it is important to maintain the patient’s intake of fluids and soft foods.”  (This concludes the information from The Ship’s Medicine Chest.)

The following information from other sources may aid in the treatment of whooping cough.

Drink lots of water to loosen mucus and ease any kind of cough.  This works better than any medicine.[6]

Treatment

Antibiotics may help in the early stage of whooping cough, before the whooping actually begins.  Erythromycin or ampicillin are typically administered.  It is critical to treat infants under the age of 6 months at the first sign.[7]  Azithromycin is another option, a single dose of 500 mg on day 1, 250 mg days 2-5.[8]  Pediatric dose varies depending on the infection, but is commonly a single dose of 10 mg/kg on day 1, followed by 5 mg/kg on days 2-5.

In infants, a pause between breaths (apnea) may become noticeable.  If the baby stops breathing after a cough, turn him over and pull the sticky mucus from his mouth with your fingers.  Then slap him on the back with a flat hand.[9]

To avoid weight loss and malnutrition, be sure the child gets enough food.  Make sure he eats and drinks shortly after vomiting. 

Bleeding inside the white of the eyes may be caused by the coughing.  No treatment is necessary.[10]

The following herbs were used by Native Americans and early settlers to treat whooping cough. 

• Henbane[11]  
• Brewer’s angelica (Angelica breweri Gray), boiled roots[12]
• Ox-eye Daisy (Leucanthemum vulgare Lam, Chrysanthemum leucanthemum L., flowers and leaves in a tea[13]
• Western Sweet Cicely (Osmorhiza occidentalis), root tea[14]
• Gumweed (Grindelia squarrosa, Grindelia camporum) [15]
• Arrow-leafed balsam root (Balsamorhiza sagittata), root tea[16]
• Red clover (Trifolium pratense)[17]
• Mock pennyroyal (Hedeoma drummondii Benth), leaf tea[18]
• Broad bitter dock (Rumex obtusifolius)[19]
• Labrador tea (Ledum groenlandicum Oeder), tea[20]
• Black raspberry (Rubus occidentalis L.), decoction of the roots, stalks, and leaves[21] 

Note.  In the United States, whooping cough is most common in the late summer months.[22]

Links to related posts:

Diphtheria 

Tetanus at TEOTWAWKI--Is It Always Fatal?

Medicinal Uses of Gumweed

Azithromycin

Cold, Influenza, and Illnesses that Look Like Colds

The Ship’s Medicine Chest and Medical Aid at Sea

References:

The Ship’s Medicine Chest and Medical Aid at Sea, 1978, p 192-93. 

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[1] David Werner, Where There Is No Doctor, 313.

[2] Ibid.

[3] Survival and Austere Medicine, 3^rd Edition, 296.

[4] Where There Is No Doctor, 313.

[5] Survival and Austere Medicine, 3^rd Edition, 296.

[6] Where There Is No Doctor, 168.

[7] Ibid, 313.

[8] Joseph Alton, Alton’s Antibiotics, 172.

[9] Where There Is No Doctor, 313.

[10] Ibid.

[11] Charles Kane, Medicinal Plants of the Western Mountain States, 169.

[12] Steven Foster, et al., Western Medicinal Plants and Herbs, 65.

[13] Ibid, 94.

[14] Ibid, 126.

[15] Ibid, 132-33.

[16] Ibid, 147-48.

[17] Ibid, 159.

[18] Ibid, 202.

[19] Ibid, 239.

[20] Ibid, 289.

[21] Ibid, 300.

 [22] Bordetella pertussis and Bordetella parapertussis, Molecular detection, PCR, Varies, Mayo Clinic Laboratories, https://www.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/80910 (accessed 16 November 2021).

6 january 2021