Treatment for whooping cough varies, depending on the age and the severity of signs and symptoms.
Older children, teens, and adults: When whooping cough is diagnosed early in older children, teenagers, and adults, doctors usually prescribe vaccination, bed rest, and an antibiotic such as azithromycin (Zithromax®) or erythromycin (E-mycin®, Eryped®). Although antibiotics will not cure whooping cough, they can shorten the duration of the illness and they shorten the period of communicability. If there is a confirmed diagnosis but a slow response to antibiotic therapy, it may be necessary to take the antibiotic for at least two weeks and maybe longer.
If the illness has progressed to the point of severe coughing spells, antibiotics are not as effective but may still be used. Unfortunately, there are few medications that help provide relief from the symptoms of whooping cough. Over-the-counter (OTC) cough medicines, such as dextromathorpan (Robitussin®), generally have little effect on whooping cough. A case of whooping cough usually resolves in six weeks but may last longer.
Infants and toddlers: Almost all infants with whooping cough who are younger than two months, as well as many older babies, are admitted to the hospital due to the potential severity and risks of whooping cough. Most babies treated for whooping cough overcome the condition without lasting effects, but the risk exists until the infection clears. In the hospital, the infant is likely to receive intravenous (IV or in the veins) antibiotics, such as erythromycin, to treat the infection and perhaps corticosteroid drugs, such as hydrocortisone, to help reduce lung inflammation. Sometimes an infant's airway may also be suctioned to remove mucus that is blocking it. The infant's breathing will be carefully monitored in case extra oxygen is needed. If the infant cannot keep down liquids or food, intravenous (IV) fluids may be necessary. In some cases, prescription sedatives (such as lorazepam or Ativan®) will help the infant rest. The infant will also be isolated from others to prevent the infection from spreading.
There are a lack of clinical studies that support the use of integrative medicine in whooping cough. However, studies do support treatment with related conditions, such as cough and upper respiratory symptoms.
Good scientific evidence
Iron: Iron is an essential mineral and an important component of proteins involved in oxygen transport and metabolism. Iron is also an essential cofactor in the synthesis of neurotransmitters such as dopamine, norepinephrine, and serotonin. About 15% of the body's iron is stored for future needs and mobilized when dietary intake is inadequate. The body usually maintains normal iron status by controlling the amount of iron absorbed from food. Taking iron orally seems to inhibit cough associated with angiotensin converting enzyme (ACE) inhibitors, such as captopril (Capoten®), enalapril (Vasotec®), and lisinopril (Prinivil®, Zestril®). Iron therapy should be initiated under the supervision of a healthcare provider.
Unclear or conflicting scientific evidence
Eucalyptus oil: Aromatherapy is a technique in which essential oils from plants are used with the intention of preventing or treating illness, reducing stress, or enhancing well-being. Despite widespread use in over-the-counter agents and vapors, there is not enough scientific evidence for using eucalyptus (E. globulus) oil as a decongestant-expectorant (by mouth or inhaled form). The available studies have been poor quality, and have used combination therapies or 1,8-cineole (eucalyptol), which is a component of eucalyptus. Further study is needed.
Fennel: Fennel (Foeniculum vulgare) fruit may be helpful in relieving cough (a side effect of angiotensin converting enzyme inhibitor [ACEI]). However, there is insufficient evidence for or against its use for ACEI-induced cough.
Peppermint oil: Although some studies support the use of peppermint (Mentha piperita) oil for cough, there is currently insufficient evidence available to determine the efficacy of peppermint oil in the management of cough.
White horehound: Since ancient Egypt, white horehound (Marrubium vulgare) has been used as an expectorant (to facilitate removal of mucus from the lungs or throat). Ayurvedic, Native American and Australian Aboriginal medicines have traditionally used white horehound to treat respiratory (lung) conditions. The U.S. Food and Drug Administration (FDA) banned horehound from cough drops in 1989 due to insufficient evidence supporting its effectiveness. However, horehound is currently widely used in Europe, and can be found in European-made herbal cough remedies sold in the United States (for example, Ricola®).
Traditional or theoretical uses
Integrative therapies used in whooping cough that have historical or theoretical uses but lack sufficient clinical evidence include: 5-HTP (5-hydroxytryptophan), abuta (Cissampelos pareira), acerola (Malpighia glabra, Malpighia punicifolia), homeopathic aconite (Aconitum napellus), acupuncture, adrenal extract, American pennyroyal (Hedeoma pulegioides), anise (Pimpinella anisum),bee pollen, berberine, bilberry (Vaccinium myrtillus), black currant (Ribes nigrum), bloodroot (Sanguinaria canadensis), boswellia (Boswellia serrata), butterbur (Petasites hybridus), chamomile (Matricaria recutita, Chamaemelum nobile),clove (Eugenia aromatica) and clove oil (Eugenol), comfrey (Symphytum spp.), devil's club (Oplopanax horridus), English ivy (Hedera helix), eyebright (Euphrasia officinalis), fennel (Foeniculum vulgare), goldenseal (Hydrastis canadensis), ground ivy (Glechoma hederacea), holy basil (Ocimum sanctum), honey, horseradish (Armoracia rusticana, Cochlearia armoracia), hyssop (Hyssopus officinalis), iridology, marshmallow (Althaea officinalis), mastic (Pistacia lentiscus), mullein (Verbascum thapsus), ozone therapy, skunk cabbage (Symplocarpus foetidus), squill (Urginea maritima, Scilla maritima), thyme (Thymus vulgaris), and thymol.
Experts believe that up to 80% of non-immunized family members will develop whooping cough if they live in the same house as someone who has the infection. For this reason, anyone who comes into close contact with an individual who has whooping cough should receive antibiotics to prevent spread of the disease. Young children who have not received all five doses of the vaccine may require a booster dose if exposed to an infected family member.
Children: The best way to prevent whooping cough is with the pertussis vaccine, which doctors often give in combination with vaccines against two other serious diseases, diphtheria and tetanus. This three-in-one combination is known as the DTaP vaccine. It is a newer and safer version of the DTaP vaccine, which is no longer used in the United States. Doctors recommend beginning DTaP vaccination during infancy. The vaccine consists of a series of five shots, typically given in the arm and given to children at these ages: two months; four months; six months; 12-18 months; and four to six years. It takes at least three shots of the pertussis vaccine to fully protect a child against whooping cough, but a total of five shots are recommended by age six.
Because immunity from the pertussis vaccine tends to wane by age 11, and because of the increase in cases of whooping cough in adolescents and teens between 11-18 years of age, doctors now recommend a booster shot for those in this age group (the tetanus, diphtheria and pertussis vaccine, or Tdap. DTaP is the name of the pediatric vaccine; Tdap is the name of the booster for people 11 years of age and older. The booster is given preferably at ages 11-12. This is in place of the traditional tetanus and diphtheria (Td) vaccine received at this age.
Adults: The U.S. Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices also advises adults to receive a Tdap booster shot every ten years. The Tdap vaccine helps protect adults from pertussis and reduces the risk of them transmitting the infection to infants. Adults who are or will be in close contact with infants under 12 months of age should also receive the vaccine. Side effects of the vaccine may include fever, crankiness, vomiting, or soreness at the site of the injection. These problems are more likely to occur after the fourth or fifth dose of the DTaP series than after earlier doses. After late doses, some children may develop swelling of the arm or leg in which the shot was given. In rare cases, severe side effects may occur including: serious allergic reactions, in which hives or a rash develop within minutes of the injection; high fever, greater than 105 degrees Fahrenheit; and seizures, shock, or coma.
Some individuals are concerned that the pertussis vaccine may cause neurological (nerve) damage because some children have developed brain damage after the immunizations. So far, however, researchers have not found a definitive link between the pertussis vaccine and brain damage. Still, research into this issue is ongoing. Children with known seizure or brain disorders may not be candidates for the DTaP vaccine.
In 2002, the U.S. Food and Drug Administration (FDA) approved a combination pertussis vaccine called Pediarix®. In addition to helping protect against pertussis, diphtheria, and tetanus, Pediarix® immunizes children against polio and hepatitis B (a serious viral liver infection). Because Pediarix® protects against five diseases, children need fewer shots. However, the vaccine also causes a wider range of side effects than does DTaP. In studies, the most common side effects of Pediarix® were pain, redness, and swelling where the shot was given, fever, and fussiness. A pediatrician will help individuals choose the best vaccination for their child.
Antibiotics: If a member of a household develops whooping cough, a doctor will likely prescribe antibiotics for the whole family to prevent spread of the infection to anyone else. Antibiotic treatment may also be prescribed for individuals and their families who have been exposed to B. pertussis in the workplace or in public.