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Whooping Cough: What You Need to Know

July 28, 2010

Public health officials across California are on the alert because the contagious disease called whooping cough, or pertussis, is once again on the rise. And this year, the statistics are more alarming. So far this year, 37 cases have been reported in Alameda County.

"We generally see an increase in the number of cases of whooping cough about every five years," reports Dianne Martin, MD, Fremont internist and infectious disease specialist who is on the medical staff at Washington Hospital. "But this year, the numbers are trending quite a bit higher, and we’re not yet sure why."

Whooping cough is a highly contagious bacterial disease that causes an uncontrollable cough, often leading to a whooping sound as the person breathes in after coughing. The respiratory disease is generally transmitted from the infected person to others via the droplets of mucus that can disburse in the air when the person coughs.

The illness is generally associated with children, with 70 percent of cases occurring in babies under six months of age. However, people of any age can be affected. Before a pertussis vaccine was developed, whooping cough was one of the most common childhood illnesses and a major cause of childhood deaths in this country. In the early twentieth century, whooping cough killed between 5,000 and 10,000 Americans each year. Once doctors began routinely giving the combination DPT (diphtheria, pertussis, tetanus) vaccine series to children, incidence of the disease dropped dramatically.

What many people may not know is that the effectiveness of the vaccine weakens over time. This means adolescents and teens can be more susceptible to the disease and should be given a booster. Even adults should be vaccinated.

"It is generally recommended that adolescents and adults get immunized every 10 to 15 years," adds Dr. Martin. "We now have the advantage of having an adult combined vaccine that includes a pertussis vaccine called Tdap, which can also be given to teens."

Usually, people recover from whooping cough without any problems, although the cough can last six to ten weeks. The heavy coughing can occasionally cause side effects like bruised or cracked ribs, abdominal hernias or broken blood vessels. Whooping cough in children, especially babies, can be far more serious. Complications can include ear infections, dehydration, respiratory distress, pneumonia, and in more severe cases the child may experience seizures and even brain damage.

"Because whooping cough can be so much more severe in children and infants, our main target population for getting vaccinated is adults who are around children a lot, such as childcare providers, grandparents who help care for their grandchildren, teachers and health care workers," says Dr. Martin. "Because the initial vaccine series begins to wear off by adolescence, it is a good idea for this age group to get the booster, especially if they will be in a group setting. During the summer, youngsters who are involved in activities like camping or sports camps should have a booster."

One of the problems with whooping cough is that it is hard to recognize. People usually think they just have a persistent cough that will not go away. Typical symptoms are like a cold but without the fever. When they finally go to the doctor, the illness is more advanced and can be more difficult to treat.

"This has also been a very bad year for allergies, so people might attribute a persistent cough to that rather than to whooping cough," observes Dr. Martin.

If you’re not sure when you had your last whooping cough booster, especially if you are around small children a lot, now is a good time to check with your primary care physician about getting immunized. The vaccine is available for all who need it.

Washington Hospital's website has a new webpage dedicated to whooping cough information. Visit www.whhs.com/cough or visit the Web site of the Centers for Disease Control at www.cdc.gov.