Here is a brief explanation of what to do if you suspect your child has whooping cough. This page will be expanded into a full explanation soon. Here are some highlights:
1. It’s contagious for about 3 weeks from when the runny nose and cough start, so keep your child home.
2. Treatment with high dose vitamin C (sodium ascorbate white powder version) may reduce the severity of the coughing fits, but you may need to double the doses that I list under treatments for regular coughs on the cough, cold, flu and nasal congestion page. For infants less than 2 years, I don’t give specific dosing on that page, but you can safely begin the listed two-year-old dosing on a younger infant as long as there isn’t severe diarrhea. This may reduce the cough.
3. Treatment with azithromycin antibiotics, if started within a few days of the onset of the severe cough, may also reduce the severity of the coughing fits and help resolve them completely. This also will make a child no longer contagious after the 5 days of antibiotic treatment. But the longer you wait to get antibiotics, then less they will work, and they are unlikely to help reduce the coughing fits at all if you wait more than 5 days after the severe coughing fits start. So, if you want antibiotics, contact our office early in the course of the illness. Treating exposed family members with antibiotics may prevent the illness completely if started before they show symptoms. Or, you can start antibiotics in family members at the very first sign of coughing, and you will likely see the illness resolve quickly.
4. If you don’t use antibiotics, it’s possible the coughing fits will last for as long as 3 months. The vitamin C may reduce this severity of these and may reduce the number of weeks that the cough will last, but it also may not help. The best way to help the illness to resolve quickly and not become severe is to start antibiotics within the first day or two of severe coughing fits, or at least within the first 5 days. Otherwise, you are stuck riding it out for an unpredictable amount of time, possibly as long as 3 months.
5. The diagnosis is usually made simply by observing the cough. Since kids usually won’t cough at the doctor’s office, a video of the severe fits is essential so the doctor can see how bad the coughing is. Nasal swab testing can be done to confirm the illness, but it is considerably inaccurate in that it often misses the germs and has a high rate of false negative results. It is more likely to be positive if done in the first day or two or severe coughing, but even then it can miss the germs. One value of testing, however, is that if the illness is confirmed this way, the public health department will be contacted to enlist their help in making sure the sick person is properly quarantined and any exposed family members limit their exposure to others.
