A bacterium known as Bordetella pertussis causes "whooping cough". The name refers to the whooping sound made upon breathing in during a prolonged coughing spell. This vaccine-preventable illness can be life-threatening to young children and even the elderly. In its early stages, it looks like the common cold, but then it develops into unrelenting coughing spells that often interfere with breathing. Whooping cough is also termed pertussis.
Whooping cough is also known as the "100 day cough" because coughing fits can last up to 10 weeks. Whooping cough symptoms may not present themselves until 5 to 21 days after exposure to someone with whooping cough.
Bordetella pertussis is considered an atypical bacterium that does not enter the bloodstream. It stays in the upper airways and interferes with the body's ability to clear airway secretions by infecting the cells needed for this function. It spreads easily from person to person and can often be mistaken for the common cold in the early phases of infection.
If a person infected with Bordetella pertussis sneezes, laughs, or coughs, small droplets that contain the bacteria may fly through the air. A nearby person may breathe in the droplets and become infected. Once the bacteria is in the lungs, they attach to small hairs in the linings of the lungs. This leads to swelling and inflammation, causing a dry, long-lasting cough and other cold-like symptoms.
Pertussis is a vaccine-preventable illness. Vaccination practices have decreased the deaths associated with whooping cough over the years. Immunization is the best way to prevent whooping cough. Two vaccines are available to prevent pertussis: the DTaP and Tdap vaccines. The DTaP is a vaccine that helps children younger than age 7 develop immunity to diphtheria, tetanus, and whooping cough (pertussis). The Tdap is a booster immunization given at age 11 that offers continued protection from the three listed diseases. The Tdap can also be given to adolescents and adults who have never been vaccinated.
The only sure way to prevent infection is through immunization; however, if you know you have been exposed to whooping cough and are likely to be infected, early treatment (within the first week) with the antibiotic erythromycin is effective in halting the progression of whooping cough.
Antibiotic treatment is only effective in preventing the later stages of the infection if it is started during the very early stages of the disease. Erythromycin is also recommended as a way to prevent infection in those who have been in close contact with infected family members. While antibiotics started after the first couple of days of infection may not change the natural course of the illness, they should still be started to prevent the spread of whooping cough to others.
Pertussis is extremely contagious. If you think you have the infection, notify your doctor as soon as possible. The quicker you get treatment, the better the chance of preventing whooping cough's progression and spread. One simple preventive measure includes hand washing and "covering your cough," as recommended by the CDC. This simply means that if you are coughing and sneezing that you cough into your sleeve and not onto your hands. This is recommended as a way to prevent the flu, colds, and other respiratory illnesses. A face mask may help prevent a person with pertussis from spreading it to others.
All infants, children, adolescents, and even adults need to ensure that they are vaccinated appropriately. Infants are most at risk for severe, life-threatening complication from whooping cough. Unlike adults, infants are suggested to have five doses of DTaP, a vaccine for diphtheria, tetanus, and pertussis. Babies should have the DTaP vaccine at 2 months, 4 months, 6 months, 15-18 months, and 4-6 years.
Babies should not get the DTaP vaccine if they are moderately or severely ill or had a life-threatening allergic reaction to the initial DTaP vaccine. Talk to your doctor if your child had the following reactions after a dose of DTaP:
- Had a seizure or collapsed
- Cried nonstop for three hours
- Had a fever over 105 F
Children ages 7 through 10 who aren't fully vaccinated, or have never been vaccinated, should get a single dose of the Tdap vaccine. Teens ages 13 through 18 should also get a single dose of Tdap if they have never been vaccinated, followed by a booster every 10 years. Ask your doctor to check your vaccine records to see if you or a family member need a booster shot.
Older children and adults should also receive a pertussis booster, even if fully immunized as an infant and child. The antibodies created after immunization become less effective within six to ten years from the last dose. This recommendation was made after observing an increase in the number of severe cases of pertussis associated with exposure to infected and minimally symptomatic teenagers and adults.
The Tdap vaccine is routinely recommended to all adults and is now given instead of the old tetanus booster (Td) that did not contain pertussis. Adults and adolescents usually have mild symptoms with pertussis infections but can often expose young infants and children who may not be completely protected by vaccination. Pregnant women should get a dose of Tdap during every pregnancy in order to protect the newborn from pertussis.
It is suggested that anyone coming in close contact with your baby be vaccinated at least two weeks before exposure; this includes grandparents, siblings, and even babysitters. Infants and children have a much higher risk of being infected by whooping cough, which makes it even more important for caregivers to be up-to-date on their Tdap vaccine.
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- Photo courtesy of CDC
- CDC: " Pertussis (Whooping Cough): About Pertussis." Nov. 18, 2019.
- CDC: " Pertussis (Whooping Cough): Pertussis Frequently Asked Questions." Nov. 18, 2019.
- CDC: "Pertussis", "Pertussis Fast Facts", "Vaccine Information Statements (VIS) Diphtheria, Tetanus, and Pertussis (DTaP) VIS", "Vaccine Information Statements (VIS) Tdap (Tetanus, Diphtheria, Pertussis) VIS"