Whooping cough, or pertussis, once killed about 8,000 people, mostly infants and children, each year in the U.S.
This was before a vaccine was developed against it. Although not 100% effective, it is still the best means we have to control the illness.
Unfortunately, several outbreaks of whooping cough have occurred in the U.S. this year, including a higher-than-normal 359 cases in Kentucky.
Pertussis, caused by a bacterium called Bordetella pertussis, is spread in tiny droplets of fluid when a contagious person sneezes, coughs or laughs.
A person is contagious for the first 1-2 weeks of the illness, or until he has had five days of appropriate antibiotics.
The time from exposure to experiencing symptoms is usually 7-10 days (but as long as 21) days.
Symptoms initially mimic those of the common cold: runny nose, sneezing, mild cough, low grade fever, and red and watery eyes.
The coughing spells then come after 1-2 weeks.
These severe bouts of coughing can last longer than a minute, making a child turn red or purple. The spells cause some children to vomit.
Characteristically, the spells end with a loud “whoop.”
Infants may gasp for air instead of coughing and may even stop breathing for a few seconds.
Older children and adults may have a prolonged cough without “whooping” spells. Hence the nickname – “the hundred-day cough.”
Complications from whooping cough in infants include pneumonia, dehydration, seizures, brain damage and death.
Older children and adults can have bruised or cracked ribs, abdominal hernias and broken blood vessels in the skin or the whites of the eyes.
Whooping cough is usually diagnosed by a swab of the throat or nose for a culture.
It is treated with antibiotics and supportive care (infants especially are sometimes hospitalized).
Prevention is by far the best way to control pertussis. The DTaP vaccine is started in early infancy and completed before elementary school. It is about 85% effective as a completed series in totally preventing whopping cough.
The other 15% may still catch pertussis but will have a milder case of it.
Immunity against pertussis starts wearing off after 8-11 years, so it is recommended that children that age receive Tdap. This is a booster that can also be given to teens and adults who have not yet had the disease.
In order to protect babies in early infancy, pregnant women are advised to receive the booster after their 20th week of gestation.