Whooping Cough Isn’t Just for Kids
By Frank Myers, Scripps Health
Whooping cough is back – with a vengeance.
Last year, California had the largest outbreak of whooping cough cases since 1947; more than 9,100 cases were reported, including 10 infants who died from the disease. While whooping cough has traditionally been considered a childhood illness, more than half of those cases involved adults and adolescents.
Whooping cough, or pertussis, is an infection of the respiratory tract caused by the Bordetella pertussis bacteria. Once in the respiratory tract, pertussis bacteria produce toxins that cause inflammation and hamper the body’s germ-fighting ability.
In its early stages, pertussis symptoms can mimic the common cold, with congestion, sneezing and runny nose, low grade fever, and a dry cough. After a week or two, the cough worsens, often causing shortness of breath, vomiting, and in some rare cases, rib fractures. Even after other symptoms have subsided, sporadic coughing fits may continue for weeks or months. In children, coughing fits may produce a “whooping” sound that gives the illness its nickname, but only 30 to 40 percent of adults and adolescents experience this.
Other symptoms can be more severe in infants and young children as well, including ear infection, dehydration, seizures and a brain disorder known as encephalopathy. In infants and very young children, pertussis can be fatal; more than half of babies under one year of age require hospitalization.
Pertussis is highly contagious during the first few weeks and can be easily contracted by inhaling contaminated droplets from an infected person’s cough or sneeze. Because the initial symptoms are easily mistaken for a common cold, adults and adolescents may not realize they have the illness, and pass it on to others in the household. If you live with someone who has pertussis, you have about a 90 percent chance of catching it.
Many infants and children who are infected contract the bacteria from parents and older siblings.
If you suspect someone in your family may have pertussis or been exposed to it, call your doctor immediately. If an infant or young child has a “whooping cough” or post cough vomiting and you cannot reach your physician, go to the emergency room. Pertussis is usually treated with antibiotics, but they must be given in the early stages. Don’t try to treat pertussis with over-the-counter cough medications, as they will not be effective and may even make the situation worse. Your physician also may recommend preventive antibiotics for family members.
In the United States, most children receive the DTaP vaccine to protect them from pertussis as well as diphtheria and tetanus; the vaccine is usually given as a series of five shots and is completed by the age of 4.
However, immunity to pertussis may weaken about ten years after the last vaccine, which helps to explain why so many older patients have been contracting it.
As a result, the Centers for Disease Control and Prevention (CDC) recommends a single dose of the Tdap vaccine for people ages 11 to 64. Tdap provides protection against tetanus, diphtheria, and pertussis for adolescents and adults. In particular, the Tdap vaccine is strongly recommended for health care workers, teachers, daycare workers, and others who work with infants and children or have an increased risk of exposure to the disease. Side effects of the Tdap vaccine are generally minimal and include pain, redness, and swelling at the injection site, headache, tiredness, nausea, and mild fever.
Recently, California enacted a state law requiring all seventh through 12th grade students to prove they have received the Tdap vaccine before August 11, 2011. August and September are the peak months for whooping cough.
If you have concerns or questions about pertussis or the Tdap vaccine, talk to your family physician.
Frank Myers is an epidemiologist with Scripps Health. “To Your Health” is brought to you by the physicians and staff at Scripps Health. For a physician referral, please visit www.scripps.org or call 1-800-SCRIPPS.
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