Incubation period days

Period of communicability 4 weeks from the first symptoms, being most infectious in the first week, before the paroxysms start.

Occurrence and distribution Whooping cough is a serious disease in tropical countries contributing to high rates of infant mortality. Vaccination programmes have markedly reduced the disease in the temperate regions of the world, but where the vaccination programme has decreased or been abandoned, it has rapidly returned as a major health problem.

Where the young infant is always carried around by its mother, there is an increased opportunity for exposure, coming into close contact with other children who might be infectious.

Control and prevention Isolation of cases, especially of young children and infants, should be instituted. Infective children should be kept away from school, markets and any place where young children are likely to congregate. Known contacts of a case of whooping cough (e.g. in the extended family of a case) should be given a booster vaccination if they have been vaccinated before, otherwise they should receive prophylactic erythromycin and vaccine.

The median age for the disease is 2 years, but because of its severity, vaccination should be started at 1-2 months. Three doses of vaccine are given, normally combined with tetanus and diphtheria as triple vaccine.

Treatment Erythromycin is only effective when given in the first week of the disease.

Fluid loss is an important cause of mortality so mothers should be encouraged to give extra fluids and breast-feed immediately after a coughing bout.

Surveillance In many countries, whooping cough is a notifiable disease.

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