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Pertussis begins with mild upper respiratory tract symptoms similar to the common cold (catarrhal stage) and progresses to cough, usually paroxysms of cough (paroxysmal stage), characterized by inspiratory whoop (gasping) after repeated cough on the same breath, which commonly is followed by vomiting. Fever is absent or minimal. Symptoms wane gradually over weeks to months (convalescent stage). Cough illness in immunized children and adults can range from typical to very mild. The duration of classic pertussis is 6 to 10 weeks. Complications among adolescents and adults include syncope, weight loss, sleep disturbance, incontinence, rib fractures, and pneumonia; among adults,...

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