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Release Date: 8/6/2012

Whooping cough resurges at alarming rate

Jack Galbraith, M.D.

Jack Galbraith, M.D., Family Medicine Specialist, St. Anthony's Medical Center

There was a time when whooping cough was a serious and widespread threat, affecting hundreds of thousands of people every year. With the development of a vaccine in 1948, that threat virtually disappeared.

Until this year. The Centers for Disease Control and Prevention (CDC) has predicted that the United States is likely to experience the worst year for whooping cough in more than 50 years. Nationwide, more than 18,000 cases of whooping cough – and nine deaths from the disease – have been reported so far this year.

Whooping cough is a highly contagious infectious disease caused by a type of bacteria called Bordetella pertussis. The infection lodges in the respiratory tract, causing a severe, hacking cough, followed by a high-pitched intake of breath that sounds like “whoop.” It spreads through droplets released when an infected person coughs or sneezes.

Typically, children are vaccinated against pertussis, administered along with diphtheria and tetanus vaccinations, at ages two months, four months, six months, 15-18 months and 4-6 years of age. Doctors recommend a booster shot around age 11 and periodic boosters throughout adulthood. The CDC recommends that a pregnant woman receive the pertussis vaccine after 20 weeks gestation, which may provide some immunity protection to her baby. Whooping cough is extremely dangerous for young infants and can prove fatal.

A number of factors may be contributing to the current whooping cough epidemic: 

  • The nationwide vaccination rate for young children is good – 84 percent – but some parents become complacent and neglect to complete the recommended series of vaccinations.
  • Some parents refuse to have their children vaccinated, fearing long-term health implications, even though studies have not confirmed any evidence of a health threat.
  • Adults, particularly those who spend time around children, need to be vaccinated or re-vaccinated, to be sure their immunity is current; many adults are unaware of this need.
  • The formula for the whooping cough vaccine was changed in 1997. While the new formula causes less of a reaction (swelling at the site of the vaccination, fever), it may wear off sooner.

Whooping cough generally starts with mild symptoms that mimic the common cold – runny nose, sneezing, watery eyes, nasal congestion, mild cough and fever. After a week or two, symptoms become more severe, with thick mucous accumulating in the airways causing violent, uncontrollable coughing. The persistent coughing fits can cause the air to leave the lungs, forcing the victim to inhale with a loud “whooping” sound. The cough can last for weeks and may cause extreme fatigue and vomiting. See your doctor if you or your child experience these symptoms.

Whooping cough is most severe for infants. Complications may include ear infections, dehydration, seizures, slowed or stopped breathing and even brain damage. More than half of all babies who get pertussis must be hospitalized and about one-fourth contract pneumonia. The disease is fatal for one to two percent of infants hospitalized with pertussis.

Your doctor can diagnose whooping cough by taking a nose or throat swab or suction sample, which is checked for bacteria. Your doctor also may take a blood sample to check for inflammation or order an X-ray to check for fluid on the lungs.

While not much can be done to ease the wracking cough – cough medicines have little effect – antibiotics can help kill the whooping cough bacteria. The patient should drink plenty of liquids, eat small meals and get lots of rest. A vaporizer can help clear the lungs.

Whooping cough is a perfect example of that old adage, “An ounce of prevention is worth a pound of cure.” Protect your children by insuring that they receive the recommended series of vaccinations, followed by appropriate booster shots. Adults should be sure their immunity is current. If you take steps to “prevent” the misery of whooping cough, you won’t have to worry about “curing” it.

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 Dr. Jack Galbraith, a Family Medicine specialist, is a member of St. Anthony’s Physician Organization. He practices at St. Anthony’s Family Health Partners, at 59 Grasso Plaza in Affton. Call 314-543-5258 for an appointment. For a referral to any St. Anthony’s physician, call 314-ANTHONY (268-4669) or 1-800-554-9550.

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