Pertussis |
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Also Listed As: |
Cough, Whooping; Whooping
Cough |
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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. |
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Signs and Symptoms |
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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):
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What Causes It? |
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A type of bacteria causes pertussis, and it is spread through droplets
coughed into the air. It is a highly contagious disease. |
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What to Expect at Your Provider's
Office |
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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. |
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Treatment Options |
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Treatment is largely to control symptoms and prevent spread. Quarantine,
parenteral fluid and nutrition, oxygen supplementation, and mechanical
ventilation may be required. |
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Drug Therapies |
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- 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.
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Surgical and Other
Procedures |
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- 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.
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Complementary and Alternative
Therapies |
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Pertussis can be treated with nutrition, herbs, and
homeopathy. |
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Nutrition |
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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).
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Herbs |
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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 (˝ 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)
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Homeopathy |
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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
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Physical Medicine |
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- 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.
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Acupuncture |
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May enhance immunity and decrease duration and severity of
infection. |
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Massage |
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Foot massage has a relaxing effect and can help induce
sleep. |
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Following Up |
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Complete recovery is expected unless there are
complications. |
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Special Considerations |
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Vaccinations are 80 to 90 percent effective. They last about 12
years. |
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Supporting Research |
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Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace
Publishers; 1995:452-453.
Behrman RE, Kliegman R, eds. Nelson Textbook of Pediatrics. 15th ed.
Philadelphia, Pa: WB Saunders Co; 1996.
Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic
Guide to Herbal Medicines. Boston, Mass: Integrative Medicine
Communications; 1998:432.
Bove M. An Encyclopedia of Natural Healing for Children and Infants.
New Canaan, Conn: Keats Publishing; 1996:205-208.
Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C
based on antioxidant and health effects in humans. Am J Clin Nutr.
1999;69(6):1086-1107.
Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines.
3rd ed. New York, NY: Penguin Putnam; 1997: 67, 72.
JAMA Patient Page. How much vitamin C do you need? JAMA.
1999;281(15):1460.
Johnston CS. Recommendations for vitamin C intake. JAMA.
1999;282(22):2118-2119.
Jonas WB, Jacobs J. Healing with Homeopathy: The Doctors' Guide. New
York, NY: Warner Books; 1996: 210-211.
Rakel RE, ed. Conn's Current Therapy. 50th ed. Philadelphia, Pa: WB
Saunders Co; 1998.
Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and
recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.
Rosen P, Barkin R, eds. Emergency Medicine: Concepts and Clinical
Practice. 4th ed. St. Louis, Mo: Mosby-Year Book; 1996.
Scott J. Natural Medicine for Children. London: Gaia Books Ltd;
1990:133-134.
Ullman D. Homeopathic Medicine for Children and Infants. New York, NY:
Penguin Putnam; 1992: 70-73.
Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Penguin
Putnam; 1995: 227-228. |
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Review Date:
August 1999 |
Reviewed By:
Participants in the review process include: Robert
A. Anderson, MD,
President, American Board of Holistic Medicine, East Wenatchee, WA; Peter
Hinderberger, MD, PhD, Ruscombe Mansion Community Health Center, Baltimore, MD;
Paul Rogers, MD, Facility Medical Director, Bright Oaks Pediatrics, Bel Air MD;
Elizabeth Wotton, ND, private practice, Sausalito,
CA.
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