Whooping Cough Woes
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Before last year, parents rarely worried about whooping cough, an ailment that somehow seemed as outdated as polio.
But when California health officials reported 9,146 cases in 2010 – the highest number in 63 years – an epidemic was declared and public health alarms sounded. Thanks to new vaccination laws and increased awareness, whooping cough cases have since declined, but officials urge continued vigilance and vaccinations.
THE 100-DAY COUGH
Medically known as “pertussis,” whooping cough is a highly contagious bacterial infection marked by violent coughing fits over a period of six to 10 weeks. Pediatricians say it’s not just the length and severity of the cough that causes concern, but complications, particularly in infants. Of California’s 10 whooping cough-related deaths in 2010, all were babies under six months old. “The big reason to vaccinate against pertussis is to protect infants who can die from the disease,” says Dr. Brett Christiansen, a pediatrician with Marshall Medical Center in Placerville. Sadly, the Center for Disease Control (CDC) estimates that one in 100 infants hospitalized with pertussis will die.
PAY ATTENTION TO SYMPTOMS
Frequently undiagnosed, pertussis initially presents as a typical cold or virus with a runny nose, mild fever and occasional cough. “Adults often have pertussis with no idea they have it,” says Christiansen. “They think they just have a cough but are walking around contagious…generally for three weeks.” On the other hand, Christiansen says children and adolescents display more “classic” symptoms, suffering from uncontrolled coughing episodes up to 15 times a day. “Kids cough, cough, cough until they are out of breath,” he explains. “Then they get the big ‘whoop,’ which makes it pretty easy to diagnose.” He adds another classic symptom is vomiting – due to the forceful coughing. Other potential complications in both children and adults include ear infections, hernias, dehydration, rib fractures and ruptured blood vessels.
PREVENTION AND VACCINATION
Health officials assert the only way to protect against whooping cough is through vaccination. For children ages 6 and under, the vaccine for pertussis is commonly given along with that for diphtheria and tetanus in a single shot called DtaP, at ages 2, 4, 6, and 15-18 months and 4 to 6 years. Because immunity wanes after five years, a booster vaccine known as Tdap is recommended for preteens – and now required in California. In 2011, the new law (requiring incoming seventh through 12th graders to show proof of the Tdap booster) went into effect. Pediatrician Maria Raslear-Hendrickson, with Mercy Medical Group, says the medical community took last year’s outbreak seriously. “When we started to see more pertussis, we jumped on top of it, immediately,” she says, noting the Tdap booster is now recommended for adults, not just school-aged kids. “It’s recommended everyone under age 65 get vaccinated, especially those around young babies,” says Raslear-Hendrickson. “New mothers are being given the pertussis vaccine before they even leave the hospital.”
PATIENTS NEED PATIENCE
Fortunately for kids and adults diagnosed with whooping cough, Raslear-Hendrickson says the treatment is a simple course of antibiotics and cough suppressants at night. However, she cautions, “While treatment cuts down on symptoms and contagiousness, the cough can still take six weeks before it is completely gone.” Raslear-Hendrickson knows from experience, having had pertussis herself last summer. “It was the worst cough of my life. It lasted six weeks, to the point where my rib cage hurt to move,” she recalls. “Really, whooping cough is a big deal. It keeps kids out of school and people out of work, and overall affects society as a whole.”