Pertussis (Whooping Cough)

Since January, in my own community, as well as in many states across the country, the numbers of cases of this highly contagious disease have been rising. Pertussis can cause serious illness, even death--and yet it is highly preventable by a vaccine. It is caused by a bacterium, Bordetella pertussis, which is spread by inhalation of contagious respiratory droplets that have been sprayed into the air when an infected person coughs or sneezes.

Signs and Symptoms

  • Cold symptoms. The illness seems like a cold for the first 1 to 2 weeks, with runny nose, cough, and maybe a slight fever. Thus, it's difficult even for physicians to pick up on a case pf pertussis.
  • Worsening cough after about 2 weeks. People typically develop "fits" of coughing-- to the point of not being able to catch their breath. During these fits, the forceful inhalations make a "whoop"-type sound.
  • Young children often don't make the whooping sound, but they can have impressive bouts of coughing. Sometimes their lips can turn blue and they will start vomiting while coughing.
  • Fatigue. Most people with pertussis become exhausted by the frequent, forceful coughing; plus, this group of patients also tends not to sleep well, due to the cough.
  • Sometimes the illness causes infants to have prolonged pauses in their breathing (apnea).
  • The cough can last for many weeks, typically at least 4 to 6.
  • This illness is usually most serious in young children and in older adults. In fact, more than half of those children less than 1 year of age who are infected with pertussis must be hospitalized. Pneumonia and seizures are typical complications.

Treatment

  •  Antibiotics. These are most effective if started during the first 3 weeks of the illness. They also decrease the spread of the illness to others.
  • Supportive care. Hospitalized patients may require oxygen--as well as intravenous fluids, since they might not be eating. Such patients might also frequently need to have the secretions in their lungs sucked out.
  • Cough medicines do not help. (Besides, these remedies are no longer recommended as an effective treatment for any illness in children under age 6.)

Prevention

  • Vaccination. A primary series of 5 diphtheria-tetanus-pertussis (DTaP) shots is recommended at 2 months, 4 months, and 6 months of age, with the fourth given between 15 months and 18 months of age. The fifth is given around the time the child begins kindergarten (4 years to 6 years of age).
  • The vaccine is a combination vaccine, meaning that it offers protection against pertussis, tetanus, and diphtheria.
  • The immunity provided by the vaccine has been found to decrease over time, so that a booster I (again containing the vaccines for diphtheria, tetanus, and pertussis--DTaP) is recommended around ages 11 or 12 years, and then every 10 years subsequently.
  • Adults who have not had a recent vaccine should consider getting vaccinated for whooping cough at least 2 weeks prior to close contact with a young infant that has not yet begun to get immunized.
  • Side effects of the vaccine are typically some redness and soreness at the injection site, and possibly a low-grade fever.

It's always worth educating yourself on the illnesses that today's vaccines are preventing. All these diseases are quite real and they do still exist--and their symptoms are much worse than any of the proven side effects of the vaccines that prevent them. For more information on pertussis, please go the website of the Centers for Disease Control and Prevention.

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