Whooping cough (whooping cough) | Health & Fitness

Chris Woolston

Whooping cough (pertussis) is a disease that should be rare by now. We’ve had an effective whooping cough vaccine for decades, but the disease continues to thrive.

An unusual outbreak of whooping cough in California in 2010, for example, sickened more than 6,000 babies and killed 10, state officials reported. It underscores the need for adults to get a whooping cough booster shot, not just for themselves, but also to protect babies who haven’t completed their full immunizations and for whom the disease can be life-threatening.

If I was vaccinated against whooping cough as a child, do I need to get more shots?

Whooping cough is usually a disease of nurseries and playgrounds. But adults can get it, too: About 28 percent of reported US cases are in adults, and the true numbers may be even higher. In fact, adults are often even more susceptible to whooping cough than young children because the vaccines most children receive eventually wear off, sometimes even in high school. (Adults can get booster shots, but few do.)

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Among adults, an estimated 20 to 30 percent of all persistent coughs (lasting two or more weeks) turn out to be whooping cough. Not only do adults get the disease, but they also pass it on to others. Children who are too young to be fully immunized are at greatest risk because the five-shot DTaP vaccine series for young children does not end until age 4 or 6 years.

What causes whooping cough?

Whooping cough, also called whooping cough, is caused by a highly contagious bacterial infection. The bacteria that cause the disease, Bordetella pertussis It travels through the air in droplets released when a person coughs or sneezes. If the whooping cough germs find a home in the trachea, the bacteria begin to produce toxins that irritate the surrounding tissues. The body responds by producing a lot of mucus that clogs the trachea and causes a ripping cough.

If you live with someone who has whooping cough, and if they haven’t been vaccinated (or have already had the disease), there’s an 80 percent chance you’ll get sick, too. Even if you have been vaccinated in the past, you can still get the disease, although it may be a milder case. Without treatment, whooping cough remains contagious for about three weeks.

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Is whooping cough dangerous?

In general, pertussis is not particularly dangerous for adults, and most can expect a full recovery without complications. Many cases are probably not even diagnosed. Often the greatest danger of whooping cough in adults is the chance that it will spread to a baby. Although most children usually recover, the disease carries a risk of serious complications, including pneumonia and brain damage.

What are the symptoms of whooping cough?

The name “whooping cough” comes from the characteristic “howling” or whistling sound children make when they gasp for breath while coughing. Adults usually don’t make this sound, and babies may not either.

At first, whooping cough looks a lot like a common cold, with sneezing, a runny nose, a dry cough, and a low-grade fever. After a week or two, the symptoms may worsen, especially the cough. In many adults, the symptoms are similar to bronchitis. In fact, it’s been called “the 100-day cough” because it lasts so long.

The cough tends to come in quick bursts (up to 15 coughs in a row) and may be worse at night. In some cases, the cough can be violent enough to break a person’s ribs. The cough is usually dry and unproductive, but can sometimes produce thick phlegm. Some people will even throw up right after a coughing fit. One feature that distinguishes whooping cough from other illnesses is that a person usually feels fine between coughing fits.

How is whooping cough diagnosed?

Whooping cough can be difficult to diagnose. But if a person has had violent coughing fits for two weeks or more, and there is no other known cause, the doctor should suspect whooping cough.

Doctors can run tests to confirm the disease, but don’t expect quick results from a culture. Culturing the bacteria, which involves taking a swab from the nasal passages and sending the sample to a lab, takes five to 12 days because the bacteria are difficult to grow. Pertussis cultures also have a high false-negative rate, meaning they miss many cases, especially late in the course of illness.

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It can be detected much faster through a polymerase chain reaction (PCR) test. A PCR test that looks for the telltale DNA of the pertussis bacteria takes only a day or two to return results. The Centers for Disease Control and Prevention (CDC) recommend doing both tests at the same time to be sure.

What is the treatment for whooping cough?

Doctors who suspect a case of whooping cough may prescribe an antibiotic such as azithromycin or erythromycin to kill the germ. These are most effective when started early in the infection. Antibiotics won’t cure the disease right away, but they can shorten the duration of symptoms. Importantly, you will no longer be contagious after five days of antibiotic treatment.

If you have whooping cough, there are steps you can take to make yourself more comfortable. That is, drink plenty of fluids and get plenty of rest. Warm, moist air can soothe your airways, so consider using a humidifier or taking lots of warm showers. You should also avoid tobacco smoke or other irritants that can trigger a coughing fit.

How can I prevent whooping cough?

All children should be vaccinated against whooping cough. The CDC recommends a series of five shots of the DTaP vaccine that protects against diphtheria, tetanus, and pertussis. Children usually get their first vaccine at 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years. Older children and teens should also get a booster dose of Tdap for long-term protection (see below for more information).

The CDC recommends that if you’re between the ages of 18 and 64, make sure you’re also up to date on your whooping cough booster (Tdap). All adults who have contact with infants or who work in health care should receive the Tdap vaccine within two years of their last tetanus shot, and other adults in the same age range should be offered the vaccine 10 years or more after your last tetanus shot, the agency says.

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However, in the event of pertussis outbreaks in the community, these adults can be vaccinated even if they received their last tetanus shot less than 10 years ago, the agency said.

Additionally, in the wake of the whooping cough outbreak in California, the CDC’s Advisory Committee on Immunization Practices, or ACIP, voted to recommend off-label use of the Tdap vaccine in two specific groups of patients. The committee now recommends that children ages 7 to 9 who have not completed the recommended childhood immunization series to protect against diphtheria, tetanus, and pertussis (DTaP) receive a catch-up dose of Tdap; Booster injections are already recommended in some formulations for ages 10 and older. It also recommends that adults over the age of 65 who have close contact with infants receive a dose of Tdap. (If you are in this age group and have not previously received Tdap, you may also receive a dose.)

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ACIP Expands Recommendations for Pertussis and Meningococcal Vaccines. AAFP News Now. American Academy of Family Physicians.

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The adults are screaming, but are the interns listening? Mark S. Dworkin, MD, MPH Annals of Internal Medicine, pages 832-835 http://www.annals.org/cgi/reprint/142/10/832.pdf

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Pertussis (whooping cough). Johns Hopkins Medicine. http://www.hopkinsmedicine.org/heic/ID/pertussis/

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American College of Thoracic Physicians. Information for patients complaining of cough. http://www.chestnet.org/downloads/patients/guides/cough/adult.pdf

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