What is Whooping Cough?
Whooping cough, also called pertussis, is a bacterial infection that causes uncontrollable coughing. The coughing can be severe and last weeks, interfering with eating and drinking and sometimes causing vomiting. In the United States, whooping cough is generally thought to be a thing of the past. However, there has recently been a significant rise in the number of whooping cough cases.
Due to the increased number of cases, The March of Dimes and Sanofi Pasteur have teamed up with actress and singer Jennifer Lopez in a widespread campaign called "Sounds of Pertussis" to educate the public about the illness. I had the opportunity to interview Alan R. Fleischman, MD, who is also the vice president and medical director of The March of Dimes. Dr. Fleischman chairs the Federal Advisory Committee to the National Children’s Study at the National Institute of Child Health and Human Development, NIH, and is a Clinical Professor of Pediatrics and Clinical Professor of Epidemiology and Population Health at the Albert Einstein College of Medicine in New York.
Whooping cough can be prevented using a vaccination but it takes multiple doses of the vaccine to become sufficiently immune to the disease. The vaccine, called DTaP, is given to children in a series of five doses, the last dose given around the age of five. Dr. Fleischman, who has been a board certified pediatrician for over 30 years, attributes the increased number of cases to a new scientific finding. While children are immunized for whooping cough, the immunity is not permanent. Studies have shown that the immunity only lasts 5 to 10 years. Infants and young children are most at risk. Whooping cough is highly contagious.
According to Dr. Fleischman, the campaign is intended to encourage adolescents and adults to have a booster shot called TDaP. He also states that only 1% to 2% of adults have had this vaccination. TDaP was developed two years ago and experts believe it is the key to squelching the increasing numbers of whooping cough. The make up of TDaP has a different number of antigens than DTaP. For this reason, it is not a good vaccination for children, but it is effective on adults. The vaccine also contains no thimerosal, the mercury-based preservative that is thought by some to cause autism. Dr. Fleischman also states that no studies have shown a relationship between autism and vaccinations.
Symptoms of Whooping CoughThe first symptoms of whooping cough are similar to that of the common cold and include:
- dry cough
- runny nose
- red watery eyes
- low grade fever
- The cough becomes productive, bringing up thick mucous.
- Coughing spells increase in duration sometimes lasting as long as a minute.
- The child may turn a blue or red coloration while coughing due to a lack of adequate oxygen.
- When the coughing spell ends, the child may make a characteristic "whooping" sound as they gasp in an effort to take in oxygen.
- Sometimes coughing spells are so severe that they can result in a rupture of the tiny blood vessels called capillaries. This manifests in the whites of the eyes or as small red dots on the skin called petichiae.
- Coughing spells may become severe enough to cause vomiting.
Diagnosing Whooping CoughWhooping cough is difficult to diagnose in its early stages since the symptoms coincide with so many other common infections. According to Dr. Fleischman, the majority of physicians in the United States have never seen a severe case of whooping cough. It can easily be confused with a cold or bronchitis. Doctors don't usually suspect whooping cough until the characteristic "whooping" sound is made. If your doctor suspects whooping cough, he can take samples of secretions from the nose and throat and send it to a laboratory for evaluation. This is called a culture. Other blood tests and images of the lungs via x-ray may help rule out other disorders and are helpful because whooping cough can often lead to pneumonia.
How is Whooping Cough TreatedWhooping cough is treated by antibiotics, particularly erythromycin or azithromycin. Unfortunately, these drugs are most helpful in shortening the period of time in which a person is contagious and may not cure the disease. Monitoring the child will be necessary to make sure he has adequate oxygen and fluids. Vomiting may be avoided by giving only small amounts of liquid and food at a time. In severe cases, an infant or small child may have to be hospitalized. In the hospital, thick mucous can be suctioned and extra oxygen provided. Intravenous fluids can prevent dehydration and because the coughing spells cause vomiting a feeding tube or parenteral nutrition (nutrients given directly into the blood stream) may be necessary.
Preventing Whooping Cough
Because whooping cough can be difficult to treat, especially in infants, prevention is the best treatment. Dr. Fleichman says that without immunization some of these children will die. Also, as the disease spreads, similar precautions that have been taken to stop the spread of Swine Flu will have to be taken, including the closing of schools.
Children under five are still vulnerable to the disease since the course of vaccination is not complete. For this reason, The March of Dimes along with Sanofi Pasteur are encouraging pregnant mothers and parents of small children to become vaccinated themselves to prevent passing the infection to their young children.
If you have been exposed to someone with whooping cough, the medical community suggests you be given prophylactic antibiotics to prevent or stop the infection.
You can also visit the March of Dimes website to find out how you can become involved in stopping the spread of whooping cough.
Incidence of Whooping Cough
According to Dr. Fleischman, there was a 100% increase in the cases of whooping cough in the United States between 2003 and 2006. Experts estimate there are more than a million cases of whooping cough a year. Most of these infections are in adults but could easily be passed on to small child.