SYMPTOMS: In a typical case, the child with whooping cough
gets severe bouts of cough. He coughs and coughs, his face
becomes red, he grasps something for support and then makes a
funny kind of sound (a ‘whoop’), as if he were taking a deep
breath in, through the partially-closed upper end of his
windpipe. The whole episode is often followed by a vomit.
Children who have had whooping cough vaccine as a part of DPT,
either do not get the disease or get it in a milder form without
the typical whoop and the vomit. A history of contact with a
case of whooping cough aids in making the diagnosis.
MANAGEMENT: I would not delay the use of antibiotics in whooping
cough. The drug of choice is erythromycin, which is started as
soon as the diagnosis is made. The drug is more effective if
started early in the course of the disease. Some believe that it
does not help the patient, but reduces the infectiousness to
others. I beg to differ and feel that it is helpful and should
be given in full dose for a period of 2 weeks. I have also found
a drug, salbutamol, commonly used for the treatment of asthma,
to be of help in reducing the severity of the bouts of cough. A
calm, smokeless environment is of great help to a small baby.
The mother’s lap is a great comfort for the child. A feed
given soon after a vomit is often retained.
If people in contact with the baby are given erythromycin for a
period of 10 days, they are likely to be protected to a
significant extent.
