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Whooping cough – Doctor to doctor.

Dear Doctor,

Your patient has given you this because they have self diagnosed from my website whoopingcough.net. I am a family doctor and acknowledged expert in this disease.
 
It is very likely they have whooping cough (pertussis).
 
The main characteristic of whooping cough is attacks of violent, uncontrollable coughing followed by long periods without coughing, lasting several weeks (average is 12 paroxysms a day). It is frequently complicated by a pre-existing viral URTI or secondary infection.
 
It is commoner than people think. It mainly affects teens and adults nowadays.
 
It is very difficult to diagnose because it does not make people ill and the severe coughing only happens every few hours. You have to ask about attacks of coughing and you have to believe they are as bad as described. 
 
The attacks of coughing continue for 3 weeks and sometimes 3 months.
 
Everyone with whooping cough has been immunized in the past. Immunization may only last for 5 to 10 years. Frequently it is less.
 

Whooping cough is best recognised by hearing or seeing a whooping cough paroxysm. I therefore recommend that possible sufferers record a paroxysmal episode and show it to their doctor. Seeing or hearing is believing!

The majority don’t ‘whoop’. Most cases go unrecognised because the patient looks well, there are no physical signs and you never hear them cough.

Most labs can now do simple blood test for pertussis toxin IgG. Ask for “pertussis antibodies” at least 2 weeks into the illness. PCR can be done on a dry throat swab any time in the first few weeks. Oral fluid tests are also done after 2 weeks.

WHO clinical diagnosis requires 3 weeks of paroxysmal coughing only.

13% of adults get a subclinical or asymptomatic pertussis infection each year.

6% of adults get a symptomatic pertussis infection each year, usually undiagnosed. Immunity from natural infection only lasts about 10 years.

Any doctor is welcome to phone me.

Dr Doug Jenkinson, Gotham, Nottingham England. +44 7584036300

Review

This page has been reviewed and updated by Dr Douglas Jenkinson 9 November 2019

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