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Distinguishing Between Croup and Whooping Cough: Symptoms, Causes, and Treatment

Updated: Jul 4


Distinguishing Between Croup and Whooping Cough

Croup and whooping cough are both respiratory infections, with croup being the more common of the two conditions. Whooping cough is an infection found worldwide. The recent rise in case numbers across Europe may be due to falling vaccine uptake. Both conditions manifest as severe coughing episodes, but they have distinct causes, symptoms and importance. Understanding the differences between the two conditions is crucial for proper diagnosis and treatment. Knowing that whooping cough is caused by bacteria is important, as treatment is different for each.


What is the Definition of Whooping and Barking cough

Pertussis, also known as Whooping cough, is a highly contagious bacterial infection that affects both children and adults. On the other hand, croup is a viral respiratory infection that often causes a barking cough due to mild swelling in the upper airways, typically in infants and young children. Most parents cannot easily tell the difference between both.


Whooping Cough

Whooping cough is characterised by severe coughing fits followed by a distinctive "whooping" sound as the individual gasps for air. It is primarily caused by the bacterium Bordetella Pertussis and can be prevented by the pertussis component of the DTaP vaccine.


Barking Cough

In contrast, croup causes a barking cough resembling the sound that seals make. Viruses that cause croup are typically parainfluenza viruses, although Respiratory Syncytial Virus or RSV is also a relatively common cause of croup. This virus is also the cause of bronchiolitis, a respiratory illness which mimics asthma in young infants. Children with croup may also exhibit symptoms similar to the common cold, like a runny nose, sore throat and cough, which is initially mild before the barking cough develops. The cough sounds like a seals bark. Croup cases are typically self resolving and symptoms are usually milder.


What are the differences between Whooping and Barking cough

The key disparities between whooping cough and croup lie in their underlying causes; while whooping cough is bacterial, croup is typically viral. Additionally, whooping cough usually lasts much longer than croup and is the more significant condition. Understanding these discrepancies is essential for effective management of each condition. Adults and much older children do not often develop croup.


Symptoms of Croup and Whooping Cough

When it comes to the signs and symptoms of croup and whooping cough, understanding what leads to their manifestation is crucial for proper identification and management. Both conditions share commonalities, such as severe coughing episodes, but they have distinct effects on various parts of the respiratory tract or system. This in turn produces the difference in presenting features. Children with croup present with a barking cough, whereas those with whooping cough showcase intense coughing episodes accompanied by the distinctive "whoop" sound, when they attempt to catch their breath.


What leads to the symptoms of both

 In croup, viruses like parainfluenza are the usual culprits. Croup causes swelling in the upper airways and voice box, leading to a distinctive barking cough. Young infants who get croup may also develop stridor. On the other hand, whooping cough, caused by Bordetella pertussis bacteria, results in inflammation lower down in the respiratory tract, including the smaller airways, leading to severe coughing fits followed by the characteristic "whooping" sound as the person gasps for air.


Common Symptoms to Watch For

Common symptoms may include coughing spells, difficulty breathing, respiratory distress, and sometimes a runny nose.


Key Differences in Symptom Presentation

The key differences in symptom presentation between croup and whooping cough lie in the nature of the cough itself. Croup cough is characterized by a barking sound resembling a seal, often preceded by cold-like symptoms. In contrast, whooping cough features severe bouts of coughing with the characteristic "whoop" sound as the individual gasps for breath at the end of a cough spasm.


Distinguishing Between Croup and Whooping Cough

Causes of Croup and Whooping Cough

The cause of Croup is a viral infection, whereas whooping cough is caused by a bacterium. Understanding the viral and bacterial causes of croup and whooping cough is essential for effective treatment and prevention strategies. The difference between croup and whooping cough impacts treatment plans.


Understanding Viral Causes

Croup is usually caused by viral infections, such as parainfluenza virus, that lead to inflammation and swelling in the upper airways, resulting in the classic barking cough. This viral origin of croup underscores the similarities with the common cold. This also explains its typically less severe nature and shorter course. Like other viral infections, croup is contagious.


Bacterial Involvement in Pertussis

Whooping cough, also known as pertussis, is predominantly caused by the bacterium Bordetella Pertussis. This highly contagious bacterial infection is preventable through vaccination during infancy and often requires antibiotic treatment to manage symptoms effectively. Understanding the bacterial aspect of whooping cough is crucial for early intervention and containment of the disease. Patients with pertussis may remain infectious for up to four weeks after they first become unwell. During that time, it is important to keep away from vulnerable individuals, including those with an incomplete course of pertussis immunisation.


Treatment Approaches

When it comes to managing respiratory illnesses like croup and whooping cough, various treatment approaches can be considered based on the age of the child, severity of the condition and the individual's overall health.


Managing Croup with Home Remedies

For mild cases of croup, home remedies can help alleviate symptoms. Humidifiers or steam from a hot shower can ease breathing difficulties, while keeping the child hydrated and providing a calm environment can support recovery. Moderate to severe croup may require attendance to the clinic, or treatment.


Managing Pertussis with Home Remedies

Home care for whooping cough may involve rest, staying hydrated, and using a humidifier to alleviate coughing spells. However, due to the contagious nature of pertussis, seeking medical attention and antibiotics is crucial.


Medical Interventions for Whooping Cough

In all cases, antibiotics are needed to treat whooping cough. For severe cases of whooping cough, hospitalisation for additional medical interventions such as oxygen and other respiratory support is necessary to manage severe symptoms and prevent complications. Whooping cough is a bacterial infection that can be severe. Children are typically provided with the DTap vaccine which aids in preventing pertussis in the first place. Increasingly in some countries, the pertussis vaccine is also offered to women during pregnancy. This reduces the risk of newborns contracting the illness prior to receiving their first dose of DTaP vaccine.


Medical interventions for Barking Cough

Managing a barking cough caused by croup may require medical interventions like corticosteroids to reduce airway inflammation and improve breathing. Severe croup can be life-threatening, requiring admission to hospital especially in young children under the age of 6 months. However this is rare. Unlike whooping cough, there is no vaccine for croup.



Distinguishing Between Croup and Whooping Cough


What are the investigations of whooping and barking cough?


What investigations are conducted for whooping cough

Diagnosing whooping cough typically involves getting a clear storyline, physical examination and throat swabs for bacterial testing to confirm the presence of Bordetella pertussis. Other tests include blood tests. Chest X-rays may also be performed to assess lung involvement, if the physical examination supports the need. Differentiating between croup usually caused by viruses and whooping cough is essential, as it does affect the investigation.


What investigations are conducted for barking cough

Unlike whooping cough, investigations for a barking cough caused by croup include physical examinations to assess the severity of respiratory distress. A key difference between whooping cough and croup is that imaging tests such as chest X-rays are rarely required in croup, as the effect on the lungs often minimal.


What are the Long-Term Effects of Whooping and barking cough?

Symptoms can persist for both so understanding the potential long-term effects of respiratory illnesses like whooping cough and barking cough is essential for comprehensive healthcare management. The difference between croup and whooping cough should be noted for accurate diagnosis.


What are the Long-Term Effects of Whooping Cough

Severe whooping cough can cause complications such as pneumonia, ear infections and occasionally seizures, particularly in infants and young children. Two weeks after the cough starts, younger infants may still have mild symptoms. In some cases, symptoms of whooping cough may persist for a few months. Whooping cough is a bacterial infection that can be fatal if not treated. The persistent coughing fits can strain the body and cause respiratory distress.


What are the Long-Term Effects of Barking Cough

While barking cough associated with croup typically resolves without long-term consequences, severe cases may result in airway obstruction or respiratory difficulties. In such cases, a child may need medical attention. Children with recurrent croup may experience chronic respiratory issues or susceptibility to future respiratory infections.


Conclusion

Recognizing the distinctions between whooping and barking cough, their respective causes, symptoms, and treatment options is paramount for accurate diagnosis and appropriate management of these respiratory conditions.

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