What is Whooping Cough (Pertussis)?
What causes whooping cough?
Whooping cough is caused by the bacteria Bordetella pertussis. A person infected with the bacteria may cough and sneeze expelling infected droplets. Sharing breathing space for extended periods can also result in transmission. These droplets can then be breathed in by those nearby, causing them to become infected. It may take 7 to 10 days to develop symptoms after becoming infected. The risk of transmission is highest during the first week or two of symptoms.
What are the symptoms of whooping cough?
Whooping cough symptoms may resemble the common cold during the first two weeks of the disease. Symptoms include:
- Runny nose
- Mild cough
- Breathing pauses (in babies).
It is during the first two weeks of cold-like symptoms that the risk of transmission to others is the highest. After this initial phase, people tend to develop “fits” of fast coughs followed by a high-pitched whooping sound. These fits can be followed by vomiting and extreme fatigue. Symptoms tend to be worse at night and can last for 2-8 weeks.
After the phase of severe coughing, the cough symptoms begin to improve and slowly go away over several weeks.
Can adults get whooping cough?
Prior to availability of vaccines, whooping cough predominantly affected children. Now, more than one-half of whooping cough cases occur in adolescents and adults. Severe disease is still more likely in infants and children. The severity of disease is typically milder in adolescents and adults due to prior vaccination, although they can still transmit the infection to unvaccinated infants and children that are at risk for severe disease.
Are people with asthma at higher risk of catching whooping cough?
Studies have found that people with asthma are at higher risk for contracting whooping cough.
Is whooping cough more dangerous for people with asthma?
Individuals with asthma may develop more severe symptoms if they contract the whooping cough. Whooping cough can also worsen asthma control, even months after diagnosis. Lastly, whooping cough in infancy or childhood increases the risk of developing asthma later in life.
How is whooping cough treated?
The main treatments are supportive: rest, hydration, small frequent meals (to prevent vomiting) and clean air (avoid irritants). Also, there should be an emphasis on preventing transmission to others. For most adults and adolescents, treatment at home is effective. Infants may require hospitalization.
Cough medications are normally not effective in treating the cough but can be tried if the cough is very severe.
If whooping cough is diagnosed within the first three weeks of symptoms, antibiotics are used during this phase. It reduces risk of transmission and may shorten the duration of symptoms. Importantly, for those with asthma (or those with COPD, pregnant or 65 years of age or older), antibiotics may still provide benefit, even up to the first six weeks of symptoms. Antibiotics are not helpful after six weeks of symptoms for anyone.
Anyone struggling to breathe, having breathing causes or turning blue should seek immediate medical care.
What are the complications of whooping cough?
Complications of whooping cough are most common in infants including:
- Apnea (slow or stop in breathing) – 61%
- Pneumonia – 23%
- Convulsions – 1.1%
- Death – 1.1%
- Encephalopathy (brain disease) – 0.3%.
Adults and adolescents may experience weight loss, loss of bladder control, fainting and rib fractures.
Can whooping cough be prevented?
The good news is there is a whooping cough shot that can prevent severe illness. The diphtheria tetanus pertussis vaccine (DTaP in infants and young children or Tdap in all others) is available at all ages, beginning at 2 months. As the name suggests, it not only protects against pertussis, but also diphtheria and tetanus.
While many people think mostly of vaccines in children, the whooping cough vaccine in adults should be given with each pregnancy. Every adult should receive a single booster after 11 years of age. Every adult also needs a tetanus booster every 10 years and this can be either just a tetanus booster or Tdap to be a pertussis booster also.
These recommendations are different for those that were not vaccinated in childhood. The purpose of the booster is to provide ongoing protection against whooping cough throughout adulthood and lessen risks to infants too young to be vaccinated.
What are the CDC pertussis vaccine recommendations?
The CDC has provided guidance for pertussis vaccine administration throughout the lifespan.
Babies and young children need 3 DTaP shots in the first year of life:
- 2 months
- 4 months
- 6 months
Then, they need a booster between 15 and 18 months and between ages 4 and 6.
Preteens and teens should get a Tdap between ages 11 and 12. If they don’t get one then, they should get one at their next well visit with a doctor.
Pregnant women should get a vaccine early in the third trimester of pregnancy.
Adults who have never received a Tdap should get one, no matter when they last had their Td (tetanus diphtheria). Then, when they receive their tetanus booster every 10 years, they can choose to get a tetanus booster that includes pertussis (Tdap).
How effective is the whooping cough vaccine?
The pertussis vaccine component of the Tdap prevents illness in 7 out of 10 adults in the first year, but that wanes over time. It protects against illness in 3-4 out of 10 adults four years after its given.
For children, the whooping cough vaccine is 98-100% effective in the first year, then 70% five years after the last shot. The vaccine is especially important for expectant mothers as it protects their newborns. If the mother received a vaccine during pregnancy, it prevents whooping cough in 78% of children under 2 months. And in babies who do get whooping cough, 90% are able to avoid hospitalization.