WHAT YOU NEED TO KNOW:

What do I need to know about pertussis in children? Pertussis, or whooping cough, is an infection of the nose, throat, and lungs. Your child's air passages narrow and get plugged with thick mucus. This may cause him to have coughing spells. Anyone can have pertussis, but it is most serious in babies and young children. A baby may get pertussis before he is old enough to get the shots to prevent the infection. Pertussis is caused by bacteria. It is easily spread in the air when someone with pertussis coughs or sneezes.

What are the signs and symptoms of pertussis in children? It may take 3 to 21 days for your child to get pertussis after contact with the bacteria. This time is called the incubation period. Pertussis begins like a cold. After a coughing spell, it may seem like your child cannot get his next breath. When the coughing ends and your child takes a breath, he may make a whooping noise. When he coughs, his face or fingertips may turn red, blue, or white because he is not getting enough oxygen. This may last 2 weeks or longer. After 2 to 4 more weeks, your child will begin to feel better. The cough may last 1 to 3 months. Your child may also have the following signs and symptoms:

• Sneezing and a stuffy nose
  
  
• Red or watery eyes
  
  
• A cough that may worsen after 7 to 14 days
  
  
• Fever
  
  
• Fatigue
  
  
• No interest in eating or drinking
  
  
• Vomiting because of the coughing
  
  
• Drooling

How is pertussis in children diagnosed? Your child's healthcare provider will do a physical exam and listen to his lungs. He will ask how long your child has been sick. Tell him if your child has other medical conditions or has been around anyone with pertussis. He may order the following tests:

• Blood tests will help your child's healthcare provider find out if he has an infection.
  
  
• A nasal swab is a test that may help healthcare providers learn which type of germ is causing your child's illness. It is done by placing a cotton swab into your child's nose to collect a sample of nasal mucus.
  
  
• A chest x-ray may be done to look for signs of infection, such as pneumonia.

How is pertussis in children treated? Babies and young children are more likely to have serious breathing problems with pertussis. They may need to go into the hospital for tests and treatment. If your child is treated at home, he may need any of the following:

• NSAIDs, such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
  
  
• Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to give your child and how often to give it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
  
  
• Antibiotics help treat or prevent a bacterial infection.

How can I manage my child's symptoms? Your child's cough may last 10 weeks or longer. It may be worse at night. Coughing helps keep mucus from clogging his lungs. Any of the following may help your child:

• Help your child during a coughing spell. If your child has a coughing spell, put him on his side in the crib or bed. This is a safe position because it will keep your child from choking if he vomits. You may also hold your child in a sitting position during a coughing spell. Help your coughing child sit up and lean forward if he is older. This makes it easier to cough and bring up mucus from the lungs.
  
  
• Help keep your baby's airways clear. Use a bulb syringe to gently clean your baby's nose. Wash the bulb syringe after each use. Clean your baby's nose before breast or bottle feeding so he can breathe easier while feeding. You may need to feed your baby smaller amounts more often if he gets tired during feedings. Clean your baby's nose before you put him down to sleep.
  
  
• Use a cool mist humidifier to increase air moisture in your home. This may make it easier for your child to breathe and help decrease his cough.
  
  
• Give your child liquids as directed. Ask how much liquid to give him each day and what liquids are best for him. You may need to give him small amounts of liquid every hour when he is awake. This will help prevent dehydration. Good liquids to drink are water or fruit juices. Limit caffeine.
  
  
• Give your child small, healthy meals often. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Healthy foods may give him energy and help him feel better.
  
  
• Help your child rest as much as possible until he begins to feel better.
  
  
• Do not smoke around your child or let anyone smoke around him. His breathing and coughing may get worse if he is near smoke.

How can I help prevent the spread of pertussis? Keep your child away from others to help prevent the spread of pertussis. Get vaccines as directed. Vaccines help protect your child and others around him from infection.

Call 911 for any of the following:

• Your child has more severe coughing spells.
  
  
• Your child is short of breath or works hard to breathe.
  
  
• The skin between his ribs or above his breast bone pulls in with each breath.
  
  
• Your child's nostrils are flaring with each breath.

When should I seek immediate care?

• Your child's lips or fingernails are blue or white.
  
  
• Your child has been vomiting and cannot keep anything down.
  
  
• Your child has the following signs of dehydration:
  • Crying without tears
    
    
  • Dry mouth or tongue
    
    
  • Fussiness, sleepiness, or dizziness
    
    
  • Sunken soft spot on the top of his head (if your baby is younger than 1 year)
    
    
  • Urinating less than usual
    
    
  • Wrinkled skin

When should I contact my child's healthcare provider?

• Your child has a fever.
  
  
• Your child is not drinking liquids.
  
  
• Your child's cough is getting worse.
  
  
• Your child is tugging his ears or has ear pain.
  
  
• Your child is not sleeping or resting because of the cough.
  
  
• You have questions or concerns about your child's condition or care.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.