Could My Child Have Whooping Cough?

During the winter months coughs and colds are plentiful. My patient's parents often ask about pertussis, otherwise known as whooping cough. Pertussis is a very distinct illness with minute-long episodes of continuous coughing that ends with a whoop sound from trying to catch a breath. It also is known as the cough of a hundred days, as the symptoms can easily last 10 weeks or longer.

The symptoms of pertussis often start out like an ordinary cough. Initially, it can be hard to distinguish the two. Viral coughs tend to improve in 10-14 days. A pertussis cough continues to worsen, and the coughing can become frequent and persistent to the point of barely being able to breathe after a long coughing fit which is the whooping sound. Pertussis can be life threatening, especially in infants. Half of infants who contract pertussis are hospitalized.  But, it’s not just infants pertussis can be life threatening for older children and adults as well. Treatment with an antibiotic will reduce a patient's risk of spreading pertussis, but unfortunately doesn't shorten the duration of the illness.

Whooping cough rates are higher now than in the past, although not at the rate of the pre-vaccine era. In 2012, according to the Center for Disease Control, over 48,000 cases of pertussis were diagnosed in the United States. Over 300 million cases were diagnosed last year alone throughout the world and that resulted in 300,000 deaths.  Pertussis should not be underestimated.

Over 10 years ago children received the DTP (diphtheria, tetanus, pertussis) vaccine, which was very effective but caused more potential side effects such as seizures, higher fevers and encephalopathy (altered brain function). The DTaP (diphtheria, tetanus and acellular pertussis) vaccine, is currently given to all children. This is a more purified derivative which was introduced in 2002 and produces fewer side effects. Unfortunately, the DTaP is not as effective as the older vaccine, which unfortunately has contributed to the rise of pertussis. Also, the rise of vaccine refusal and relying on herd immunity is another contributor. Vaccinated children and adults can still get pertussis, but the symptoms are less severe.

Current recommendations include 5 DTaP vaccines by kindergarten age, one TdaP vaccine starting at age 10, prior to 6th grade, and one booster vaccine every ten years afterwards. Pregnant women are recommended to be vaccinated during each pregnancy to protect their infant from disease, despite their prior history of TdaP vaccination. Adults are a common carrier of pertussis, as infants and children are infected primarily by adults. The protection that one receives wanes considerably towards the 10 year mark so diligence in receiving the boosters is vital.

All prolonged coughs are not pertussis.  But, if you or your child has a cough that has lasted for several weeks and does not seem to be getting better make sure you see your doctor.