Sunday, December 27, 2015

Whooping Cough - Are you at Risk?

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Studying Pertussis (Whooping Cough) - Photo by NIOSH
Pertussis is known by several names, including whooping cough and the "100 day cough." The number of reported cases in the United States has increased since 1980. This highly contagious lung infection can cause serious illness in people of all ages and is associated with nearly 200,000 deaths worldwide.

Once exposed to pertussis, a person may begin to develop symptoms in four to 21 days. This is called the incubation period.

Whooping cough typically begins with about one to two weeks of mild symptoms similar to the common cold, such as an occasional cough, runny nose, and a mild fever. Some babies in early stage do not cough at all, but they may experience pauses in breathing called apnea. People in the first stage of pertussis often do not seek medical attention or may be mistakenly diagnosed with the common cold. Unfortunately, the first stage known as the catarrhal stage, is also the most contagious, which can easily lead to outbreaks in neighborhoods.

The second stage, called the paroxysmal stage of pertussis, may last one to ten weeks. At this time, the cough changes and more severe symptoms occur. Traditionally, someone in this stage will experience multiple, rapid, and often violent coughing fits until he or she makes a "whooping" sound trying to get air back into the lungs. Some people vomit after coughing, and the person may feel exhausted after the coughing fits. The symptoms are often worse at night. This may make diagnosis more difficult because the person may not appear sick between coughing fits.

The convalescent stage, or third stage, of pertussis usually lasts two to three weeks. The coughing gradually improves, but the person may be less able to fight off other lung infections during this time.

Babies less than one year old who have not been completely vaccinated for pertussis are more likely to have complications like pneumonia and apnea; about half of babies diagnosed with whooping cough are hospitalized. People with altered immunity, such as those with cancer or autoimmune disorders, are also at greater risk for complications. Adults and teens may experience side effects related to the act of coughing, including weight loss, loss of bladder control, hernia, angina, and rib fractures.

The DTaP immunization provides some preventive protection against diptheria, tetanus, and pertussis. Recommendations for receiving DTaP are at ages 2, 4, and 6 months, between 15 and 18 months, and at 4 to 6 years. Preteens typically receive a booster; adults who have not received a booster are typically advised to get one DTaP as well. Those who have received the immunization or have had a case of whooping cough in the past can still get pertussis; however, they usually experience milder symptoms and may not make the characteristic "whoop" sound with the coughing fits, which can make the cough more difficult to recognize.

If you have symptoms of or have been exposed to pertussis or would like to see if you need a preventive booster of DTaP, check with your health care professional. He or she may ask about symptoms, perform a physical exam, and/or order tests. It may be helpful to take a video of the person having a coughing fit to show the healthcare provider. 

Whooping cough is caused by Bordetella pertussis, a bacteria that can damage cilia, structures that look like tiny hairs, in the upper airways and cause the air passages to swell. The bacteria can be treated with antibiotics; treatment is more effective if started in early stages of the illness and may help prevent the spread of the lung infection to others. People who have been in close contact with someone who has been diagnosed with pertussis are typically advised to also begin antibiotic treatment.

Sources
Centers for Disease Control and Prevention
National Institutes of Health

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