What is Whooping Cough?
Whooping cough (pertussis) is an infection of the respiratory system caused by the bacterium Bordetella pertussis (or B. pertussis). It's characterized by severe coughing spells, which can sometimes end in a "whooping" sound when the person breathes in.
It mainly affects infants younger than 6 months old before they're adequately protected by immunizations, and kids 11 to 18 years old whose immunity has started to fade. It mainly affects infants younger than 6 months old before they're adequately protected by immunizations, and kids 11 to 18 years old whose immunity has started to fade.
Signs and Symptoms
The first symptoms of whooping cough are similar to those of a common cold:
•runny nose
•sneezing
•mild cough
•low-grade fever
After about 1 to 2 weeks, the dry, irritating cough evolves into coughing spells. During a coughing spell, which can last for more than a minute, the child may turn red or purple. At the end of a spell, the child may make a characteristic whooping sound when breathing in or may vomit. Between spells, the child usually feels well.
Although many infants and younger children who become infected with B. pertussis will develop the characteristic coughing episodes and accompanying whoop, not all will. And sometimes infants don't cough or whoop as older kids do. Infants may look as if they're gasping for air with a reddened face and may actually stop breathing (called apnea) for a few seconds during particularly bad spells.
Adults and teens with whooping cough may have milder or atypical symptoms, such as a prolonged cough (rather than coughing spells) or coughing without the whoop.
Watch as this Whooping cough is very Contagiousness
Pertussis is highly contagious. The bacteria spread from person to person through tiny drops of fluid from an infected person's nose or mouth. These may become airborne when the person sneezes, coughs, or laughs. Others then can become infected by inhaling the drops or getting the drops on their hands and then touching their mouths or noses. Infected people are most contagious during the earliest stages of the illness for up to about 2 weeks after the cough begins. Antibiotics shorten the period of contagiousness to 5 days following the start of antibiotic treatment.
How to prevent Whooping cough
Whooping cough can be prevented with the pertussis vaccine, which is part of the DTaP (diphtheria, tetanus, a cellular pertussis) immunization. DTaP immunizations are routinely given in five doses before a child's sixth birthday. To give additional protection in case immunity fades, the American Academy of Pediatrics (AAP) now recommends that kids ages 11-18 get a booster shot of the new combination vaccine (called Tdap), ideally when they're 11 or 12 years old, instead of the Td booster routinely given at this age.
The Tdap vaccine is similar to DTaP but with lower concentrations of diphtheria and tetanus toxoid. It also can be given to adults who did not receive it as preteens or teens. This is especially important for those who are in close contact with infants, because babies can develop severe and potentially life-threatening complications from whooping cough. An adult’s immunity to whooping cough lessens over time, so getting vaccinated and protecting yourself against the infection also helps protect your infant or child from getting it.
As is the case with all immunization schedules, there are important exceptions and special circumstances. Your doctor will have the most current information. Experts believe that up to 80% of non-immunized family members will develop whooping cough if they live in the same house as someone who has the infection. For this reason, anyone who comes into close contact with someone who has pertussis should receive antibiotics to prevent spread of the disease. Young kids who have not received all five doses of the vaccine may require a booster dose if exposed to an infected family member.
How long this infection
The incubation period (the time between infection and the onset of symptoms) for whooping cough is usually 7 to 10 days, but can be as long as 21 days.
Duration
Pertussis usually causes prolonged symptoms — 1 to 2 weeks of common cold symptoms, followed by 2 to 4 weeks (sometimes more) of severe coughing. The last stage consists of another few weeks of recovery with gradual clearing of symptoms. In some children, the recovery period can last for months.
When to get Professional Treatment
Call the doctor if you suspect that your child has whooping cough. To make a diagnosis, the doctor will take a medical history, do a thorough physical exam, and take nose and throat mucus samples that will be examined and cultured for B. pertussis bacteria. Blood tests and a chest X-ray also might be done.
A confirmed case of whooping cough will be treated with antibiotics, usually for 2 weeks. Many experts believe that the medication is most effective in shortening the duration of the infection when given in the first stage of the illness, before coughing spells begin. But even if antibiotics are started later, they're still important because they can stop the spread of the pertussis infection to others. Ask your doctor whether preventive antibiotics or vaccine boosters for other family members are needed.
Some kids with whooping cough need to be treated in a hospital. Infants and younger children are more likely to be hospitalized because they're at greater risk for complications such as pneumonia, which occurs in about 1 in 5 children under the age of 1 year who have pertussis. Up to 75% of infants younger than 6 months old with whooping cough will receive hospital treatment. In infants younger than 6 months of age, whooping cough can even be life threatening.
Home Treatment
If your child is being treated for pertussis at home, follow the schedule for giving antibiotics exactly as your doctor prescribed. Giving cough medicine probably will not help, as even the strongest usually can't relieve the coughing spells of whooping cough. The cough is actually the body’s way of trying to clear respiratory secretions. (Due to potential side effects, cough medicines are never recommended for children under age 6.)
During recovery, let your child rest in bed and use a cool-mist vaporizer to help loosen respiratory secretions and soothe irritated lungs and breathing passages. (Be sure to follow directions for keeping it clean and mold-free.) In addition, keep your home free of irritants that can trigger coughing spells, such as aerosol sprays; tobacco smoke; and smoke from cooking, fireplaces, and wood-burning stoves.
When to Call the Doctor
Call the doctor if you suspect that your child has whooping cough or has been exposed to someone with whooping cough, even if your child has already received all scheduled pertussis immunizations.
Your child should be examined by a doctor if he or she has prolonged coughing spells, especially if this spells:
•make your child's skin or lips turn red, purple, or blue
•are followed by vomiting
•are accompanied by a whooping sound when your child breathes in after coughing
•is having difficulty breathing or seems to have brief periods of not breathing (apnea)
•is lethargic
Why this deadly Whooping cough is making a comeback in North America.
The first effective vaccine for whooping cough was developed in 1940. Before that, the respiratory infection killed thousands each year -- and it may be making a comeback. Hundreds of cases are being reported in nine states. Washington State has declared an epidemic, with 1,484 cases. Heidi Bruch of Seattle did everything she was told during her pregnancy. Unfortunately, that didn't include getting a booster shot against whooping cough. She caught the disease and passed it to her two-week-old daughter, Caroline. My heart just sank. Oh my gosh" said Bruch. "I had inadvertently given my newborn a potentially fatal disease. It was a horrible feeling.
Caroline recovered after a month in the hospital, but it was touch-and-go. Dr. Wendy Sue Swanson is a pediatrician at the Everett Clinic in Mill Creek, Wash. Her county has seen 264 cases so far; that's more than the entire state had last year at this time. Newborns and infants in particular are at highest risk for complications," Swanson said. "They can have a serious, life-threatening pneumonia. They can have pauses or cessation in their breathing, where they stop breathing. Eighty-two percent of cases have been in children under age 18. All four fatalities in Washington since 2010 were infants.
Children get their first three doses of whooping cough vaccine at two, four and six months
According to the Centers for Disease Control, 95 percent of kids in the U.S. get those first vaccinations. But immunity wears off over time. The CDC said adults need one booster shot after age 18. But today only 8 percent of adults get that recommended booster. Washington Secretary of Health Mary Selecky is urging people to get immunized. This is
about taking care of yourself, your family, but also your community," said Selecky. As a parent, you don't want to go through this," said Bruch. Having this booster available: It's a no-brainer. Go and get it.Last year, the CDC began recommending that pregnant women be vaccinated against whooping cough for two reasons: To protect mothers like Heidi Bruch; and because protective antibodies pass to a child before birth, which helps newborns too young to be vaccinated themselves.
So, why are we seeing such a rise in whooping cough right now? Isn't it a vaccine-preventable disease? Is it simply because some parents are choosing not to vaccinate their kids? Well, it would be terrific if 100 percent of children were vaccinated, but it's not that simple a solution. Infectious diseases are much more complex. Here are some important facts about whooping cough:
1. Whooping cough epidemics occur in cycles and tend to peak roughly about every three to five years. The last major epidemic was in 2005, so we were destined to see an uptick in infections this year.
2. Immunity to whooping cough does not last forever -- even if you are vaccinated for protection or you had the disease before. Immunity wears off over time (listen up, adolescents and adults!). That's why it is so important to get the whooping cough booster vaccine, called Tdap (for tetanus, diphtheria, and pertussis).
3. Babies cannot receive their first vaccination for whooping cough until they are 2 months old. Even then, they do not have adequate immunity until they have received at least three doses of whooping cough vaccine DTap (at 6 months). So, babies rely on those around them to be protected by vaccination and not spread the infection to them. Up to 80 percent of babies get whooping cough from a loved one in their household (most often, it's contracted from their moms).
4. Adults often don't know they have the illness. It may look like a common cold at the beginning of the infection; then it becomes a cough that just lingers (whooping cough is also known as the "100 Day Cough"). People are contagious up to about two weeks after the cough begins.
What can be done to fight this this deadly Whooping cough
These are the latest recommendations from the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP):
1. Adults ages 65 and up should get Tdap if they will be around infants who are younger than 1 year of age. (Previously, only those ages 64 and younger were advised to get the vaccine.)
2. Adults ages 65 and up can get Tdap as their tetanus booster if they have never received Tdap before.
3. There is no minimum time frame between the dose of Td (for tetanus and diphtheria) and giving a Tdap booster (originally it was recommended to be five years between, then two years between).
Because of the latest major outbreak, California has expanded its vaccine recommendations beyond the standard vaccination schedule. Californians who are age 7 and up who are not fully immunized; women of childbearing age, before, during or immediately after pregnancy; and anyone who has contact with pregnant women or infants should receive a booster shot for whooping cough. I know that many adult medical practices do not stock the Tdap vaccine, but ask for it, and your doctor may get it for you. If you cannot get it from your doctor, call around to your local pharmacy or even grocery store, if it has a pharmacy department.
In addition to being vaccinated, be sure to watch for signs of whooping cough:
1. A persistent cough after having symptoms of a common cold.
2. A hacking cough that is much worse at night.
3. Coughing spells that include trouble catching one's breath at the end of the spell, vomiting at the end of the spell, lips turning blue, or face turning red with the spell.
4. Making a high-pitched "whoop" noise at the end of the coughing spell.
5. A low-grade fever throughout the course of the disease.
