What to Do About Whooping Cough

Pertussis or whooping cough has been making the news lately, with outbreaks in many parts of the country. The state of Washington already has had a total of 2,520 cases this year and California had 10 infants die of the disease in 2010. North Dakota has had more than 80 cases documented so far this year and Minnesota has had high numbers of pertussis. With our mobile society it is even more important that we all do what we can to prevent the spread of this disease.

Pertussis is a highly contagious upper respiratory bacterial disease that can cause uncontrollable, violent coughing, especially in infants and children, but it can affect individuals of any age. It is a serious disease that can cause permanent disability and even death in infants. The coughing can make it difficult to breathe and a deep “whooping” sound can be heard when the individual tries to take a breath. Adults often have a prolonged cough.

Pertussis is spread when an infected person sneezes or coughs. The tiny airborne droplets containing the bacteria cause the disease to easily spread from person to person. The initial symptoms are similar to the common cold and usually occur about a week after exposure. Severe episodes of coughing may start later with the coughing ending up with a “whooping” noise in children. This whoop noise is rare in infants under 6 months of age and in adults. The coughing spells may lead to vomiting or even short spells of unconsciousness. In infants, coughing and choking spells are common and infants younger than 18 months need constant supervision as their breathing may temporarily stop during the coughing spells. Those with severe cases should be hospitalized. In older children and adults the recovery is usually good, but it is important to remember that they can spread the disease to vulnerable infants. Some complications of pertussis include pneumonia, convulsions, ear infections, permanent seizure disorders and brain damage, and even death. Everyone is at risk, but infants and unvaccinated children are at the highest risk for developing severe complications.

The initial diagnosis may be based on symptoms, but it can be difficult to diagnose when the symptoms are not obvious. In very young infants, the symptoms may be caused by pneumonia instead. To aid in the diagnosis the medical provider may test a sample of the mucus or blood. Treatment with antibiotics can make the symptoms less severe if started early enough and will help in controlling further spread of the disease. During an outbreak, children who are not fully immunized should not attend school.

Prevention of the disease is centered on vaccination. DTaP vaccination, one of the recommended childhood immunizations, protects children against pertussis (as well as diphtheria and tetanus). Five DTaPs are recommended and are usually given at 2, 4, 6, 12-18 months and at 4-6 years of age. Booster doses given in the form of Tdap are recommended for children around the ages of 11-12 years and are also recommended for adolescents and adults who have not received a dose of the Tdap vaccine. North Dakota day care and school immunization requirements include these recommendations. Requirements state that children entering kindergarten and 7th grade, as well as new students, be fully immunized with these vaccines. It is especially important that those around infants and newborns be vaccinated.So, please check your family’s immunization records to see that everyone is up to date on the pertussis containing vaccine, and if not, get vaccinated! For more information contact City-County Health District at 845-8518 or your local healthcare provider.

YOUR HEALTH column is coordinated by Mercy Hospital.