Whooping Cough (Pertussis) is BackPosted: October 29, 2012
You might have thought that whooping cough (aka “pertussis”) went the way of polio and was virtually eliminated, at least in the US, by the vaccinations that nearly everyone receives between the ages of two months and six years.
But whooping cough is back—with a vengeance. It is sickening both children and adults, and this year will likely see the highest number of victims in any year since 1959.
This is scary news, because whooping cough isn’t just any old cough. It’s a serious disease that can cause severe complications, including brain damage, permanent seizures and even death. These side effects can happen to people of any age, though babies under age one are at greatest risk.
Here’s why there’s been a spike—and how you can protect yourself.
THE VACCINATION WEARS OFF
When I called Sarah Meyer, MD, from the National Center for Immunization and Respiratory Diseases (part of the Centers for Disease Control and Prevention) in Atlanta, she said that whooping cough has gradually been increasing in the US since the 1980s and that it comes in waves every three to five years. So we could be at the peak of a wave now. But there’s another factor at play.
Though it’s effective, the whooping cough vaccination doesn’t last very long, said Dr. Meyer. That’s especially true of the newest form of the vaccine that’s recommended for kids age six and under, the DTaP vaccine, which replaced the original DTP vaccine in 1997. (The “D” in these “combination” vaccines stands for diphtheria…the “T” for tetanus…and the “P” for pertussis.) DTP was made with the entire pertussis organism and seemed to protect kids until they reached adolescence, but it was commonly associated with mild-to-moderate side effects, such as fever, loss of appetite, drowsiness, irritability and irritation at the injection site—and it was also associated with rare but severe side effects, such as allergic reactions and encephalopathy (a degenerative brain disease). The newer DTaP vaccine is made with only portions of the pertussis organism, so it causes fewer side effects, but as we’re beginning to see, it appears to lose effectiveness more quickly.
As a result, today’s middle school, high school and college kids are considered “reservoirs” of the whooping cough bacteria because at their ages, the vaccine’s protection wanes. And because whooping cough is very contagious, school kids who have it can transmit the bacteria to each other—and to their teachers and parents and younger siblings if they haven’t been vaccinated—quite easily through sneezing and coughing.
To protect yourself from whooping cough, you can ask your physician for the Tdap vaccination—available since 2005, it’s the version of the DTaP vaccination that’s considered an appropriate “booster” shot for those age seven or older, said Dr. Meyer. In fact, the CDC recommends that anyone age 11 or older—even those who got the original vaccination as young kids—get it once. For more specific information on the CDC’s recommended whooping cough vaccination schedule –
The only people who may not want to get the Tdap booster are those allergic to any component of the vaccines and those with a history of coma or seizures, said Dr. Meyer. So be sure to tell your doctor about your medical history and any allergies.
The Tdap booster, as I mentioned, has been around for only seven years, so as the length of its effectiveness is further studied, experts will determine whether more than one booster shot is necessary for adults as they age. (A booster against pertussis alone isn’t available, said Dr. Meyer.) Since the CDC recommends getting a booster for all three diseases—diphtheria, tetanus and pertussis—it makes sense to get a combination booster.
TELLING DIFFERENT COUGHS APART
But there are so many types of coughs! If you do get sick, how do you know whether what you have is whooping cough, pneumonia, bronchitis, croup or just a garden-variety upper-respiratory infection? Symptoms vary, of course, but Dr. Meyer provided some guidelines…
- Pneumonia frequently brings a fever, so you may have the sweats and the chills. People sometimes have chest pain and shortness of breath. Many symptoms improve within days of treatment, but the cough can last for weeks.
- Bronchitis usually comes on quickly, after just a few days of cold symptoms, and then leaves after two to three weeks. It causes chest discomfort, a low fever and fatigue. Some people develop a wheeze.
- Croup causes inflammation around the vocal chords and affects mostly young children. The cough can sound like a seal barking, and the person may develop stridor, a high-pitched sound when breathing in. Croup usually lasts less than a week.
- Whooping cough leads to fits of coughing that can become so extreme and uncontrollable that you can’t catch your breath, forcing you to inhale with a loud distinctive “whooping” sound. These fits can leave you vomiting, exhausted, looking blue from a lack of oxygen and even with broken ribs. Fits tend to occur a week or two after having cold symptoms—and can last up to 10 weeks. However, those who have been vaccinated typically have milder symptoms, and babies may not even cough but may have life-threatening pauses in breathing.
Whenever you have a symptom or cough that lasts any length of time that concerns you, Dr. Meyer said, don’t self-diagnose—go get checked out.
TREAT IT & BEAT IT
If you suspect that you have whooping cough, stay away from other people as much as possible—especially babies, because they’re more likely to contract the disease and suffer complications from it. Get to a doctor right away, and tell him or her that you suspect whooping cough, because, believe it or not, even many physicians don’t realize that the disease is making such a strong comeback, said Dr. Meyer. If a nasal swab confirms the diagnosis, antibiotics (and rest) will treat the infection and make you less contagious, though the cough will persist for awhile.
Source: Sarah Meyer, MD, officer, Epidemic Intelligence Service (EIS), National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta.