Pertussis

Pertussis is a violent cough, sometimes called whooping cough. A vaccine for pertussis was developed in 1948. Before then, children in the United States often died from it. The disease is rising again because fewer people are getting vaccinated.

Signs and Symptoms

The three phases of the disease are listed below.

Catarrhal phase (lasts one to two weeks):

• Upper respiratory infection; begins like the common cold
• Low-grade fever (less than 100.4°F)
• Loss of appetite

Paroxysmal phase (lasts one to four weeks):

• Cough increases (2 to 50 times a day) and fever decreases
• Sudden, forceful breathing in causes the whooping sound
• A sudden intense bout of coughing (paroxysms) causes bulging and tearing eyes, tongue sticking out, and bluish discoloration
• Vomiting or choking may follow coughing bouts

Convalescent phase (lasts two weeks to several months):

• Cough slowly goes away

What Causes It?

A type of bacteria causes pertussis, and it is spread through droplets coughed into the air. It is a highly contagious disease.

What to Expect at Your Provider's Office

Your health care provider will prescribe an antibiotic, which helps prevent the disease from spreading. Patients with complications, severe coughing bouts, or who are under one year of age are hospitalized.

Treatment Options

Treatment is largely to control symptoms and prevent spread. Quarantine, parenteral fluid and nutrition, oxygen supplementation, and mechanical ventilation may be required.

Drug Therapies

• Antibiotics—(usually erythromycin) reduce transmission and are effective even for infants.
• Corticosteroids such as betamethasone (0.075 mg daily per kilogram of body weight) may reduce severity and length of coughing fits, especially in infants.
• Albuterol (0.3 to 0.5 mg daily per kilogram of body weight) reduces the severity of coughing fits
• Do not use cough suppressants.

Surgical and Other Procedures

• In cases of loss of consciousness, immediate resuscitation is essential to avoid brain damage and death.
• Suctioning of secretions, oxygen administration, parenteral fluids and electrolytes are used for infants and in those with protracted illness.
• Mist by tent may benefit infants.

Complementary and Alternative Therapies

Pertussis can be treated with nutrition, herbs, and homeopathy.

Nutrition

Note: Doses given are for children. Adults should double the amounts.

• Eliminate dairy, bananas, wheat, and meat products.
• Encourage small, frequent meals of vegetable broths, steamed vegetables, and fresh fruit (especially pineapple and grapes).
• Vitamin C (200 to 500 mg two times per day), zinc (10 to 15 mg per day), and beta-carotene (10,000 to 25,000 IU per day).

Herbs

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots.

Catarrhal stage: Choose two herbs from each of the first three categories. Combine in equal parts in a tea (½ cup every three to four hours), a tincture or glycerite (30 drops every three to four hours).

Paroxysmal stage: In addition to the above formula, combine 2 parts of catnip with two to four of the other antispasmodic herbs in a tincture or glycerite (20 drops every one to two hours).

Immune-stimulating herbs:

• Coneflower (Echinacea purpurea)
• Usnea lichen (Usnea spp.)
• Garlic (Allium sativum)
• Astragalus (Astragalus membranaceus)

Expectorants:

• Licorice root (Glycyrrhiza glabra)
• Elecampane (Inula helenium)
• Mullein (Verbascum densiflorum)

Antiseptics:

• Thyme (Thymus vulgaris)
• Hyssop (Hyssopus officinalis)
• Anise seed (Pimpinella anisum)

Antispasmodics:

• Indian tobacco (Lobelia inflata) (not more than 1/4 of combination)
• Catnip (Nepeta cateria)
• Chamomile (Matricaria recutita)
• Cramp bark (Viburnum opulus)
• Valerian (Valeriana officinalis)

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies as a supplemental treatment for the symptoms of pertussis as long as the underlying infection has been appropriately treated. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

• Aconite — should be taken during the first 24 hours that symptoms appear, particularly if they develop following exposure to cold weather; this remedy is most appropriate for individuals with a hoarse, dry, cough who complain of dry mouth, thirst, restlessness, worsened symptoms from cold air and/or lying on the side, and being awakened from the cough
• Drosera — for dry, spasmodic cough with sharp chest pain and a tickling sensation in the throat that may cause the individual to gag, choke or vomit; this remedy is most appropriate for individuals who tend to be hoarse, become worse when lying down, and perspire during the night
• Hepar sulphuricum — for later stages of pertussis with wheezing, little mucus production, and coughing that comes on when any part of the body gets cold
• Ipecacuanha — spasmodic cough and gagging or vomiting; this remedy is commonly prescribed for infants
• Phosphorus — for several different types of cough, most particularly a dry, harsh cough described as a persistent tickle with sharp chest pain signified by the individual clutching his or her painful chest; this remedy is most appropriate for individuals who are often worn out and exhausted, have undue anxiety, even fear of death and require a lot of reassurance
• Spongia — for harsh, barking cough that produces no mucus and is associated with a tickling in the throat or chest that worsens when lying down improves when the individual eats or drinks warm liquids; this remedy is often used if Aconite was not successful

Physical Medicine

• Chest rubs. Use 3 to 6 drops of essential oil (camphor, thyme, eucalyptus, rosemary) with 1 tbsp. food-grade oil (almond, flax, or olive).
• Castor oil pack. Apply oil directly to chest, cover with a clean soft cloth and plastic wrap. Place a heat source over the pack and let sit for 30 to 60 minutes. Use daily.
• Place 3 to 6 drops of essential oil in a humidifier or a warm bath.
• Alternating hot and cold applications to the chest or back. Alternate three minutes hot with one minute cold.
• Warming sock treatment. Before bed, place cold, damp socks on warmed feet and cover with dry wool socks overnight.

Acupuncture

May enhance immunity and decrease duration and severity of infection.

Massage

Foot massage has a relaxing effect and can help induce sleep.

Following Up

Complete recovery is expected unless there are complications.

Special Considerations

Vaccinations are 80 to 90 percent effective. They last about 12 years.

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