The Scoop on the Whoop—Whooping Cough
There has been a lot of talk and press about whooping cough this year. New York had a very large outbreak mainly due to exposure from children and adults who were not vaccinated against bordetella pertussis, the bacteria that causes whooping cough. The vaccination is part of the series called Tdap, which includes tetanus, diptheria, and pertussis and is given at 2, 4, 6 and 15-18 months of age and booster shots as adults every 10 years.
Pertussis is nick-named “whooping cough” because during the coughing fits that are common with the illness children often would make a whooping sound during inspiration in between coughing spells. It usually starts as a cold, with runny nose, sneezing and mild cough and fevers. After a couple of weeks those infected start to have severe coughing attacks that can last for up to another 6 weeks. Often the cough can happen more during the night, cause vomiting, and some may have trouble breathing during these attacks for a few seconds.
The concern surrounding pertussis is that it is highly contagious. Since this is a disease of the respiratory system, it is spread through droplets from those who cough and breathed in by anyone who is in close contact with the infected person. Pertussis can lead to more severe problems such as pneumonia. However, since it is caused by a bacterial infection, antibiotics are used for treatment of the disease. Many times I will also prescribe an albuterol inhaler as well as a cough suppressant to help with the symptoms.
If you are concerned and think you may have whooping cough or have been exposed you should contact your health care provider immediately. Often the diagnosis can be made clinically, meaning by symptoms and a good physical exam. Many times a nasal or throat swab is obtained to culture for the pertussis bacteria. Only one course of the antibiotic is needed even though the cough will last for many weeks following treatment. Those infected should not go to school or work until they have been on an antibiotic for at least 5 days and their symptoms start to improve and are free of fever. Antibiotics will help to lessen the chances of complications and spread to others but does little to impact the course of the disease itself.
The best form of prevention is to make sure you and your children have been adequately vaccinated against pertussis. Young children are the most at risk until they have had at least three of the required vaccinations. A total of 5 shots are recommended by the age of 6 and teens and adults should receive a booster every 5-10 years. This is why a booster at 7th grade is given. I receive regular booster shots to not only protect myself but my family and patients as well.