Whooping Cough is Back
Whooping cough, an old-fashioned-sounding disorder is back in our midst. Whooping cough, also known as pertussis, is an extremely contagious disease. It is caused by the bacterium Bordetella pertussis, a distant relation to the bug that causes kennel cough in dogs. While an effective vaccine is available, pertussis is still one of the most commonly occurring vaccine-preventable diseases in the U.S. Prior to the availability of the vaccination, whooping cough was often fatal in infants. Nowadays, children are routinely vaccinated against diphtheria, tetanus and whooping cough using the DTaP vaccine. The booster, called Tdap, should be readministered around 11 to 12 years of age. In February of this year, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention recommended that a Tdap booster be given to all adults aged 19 and older who have not received it as an adult.
Yet despite the availability of a vaccine that is nearly 100% effective, the incidence of pertussis began to rise in the late 1980s. It becomes an epidemic in given locations every two to four years. Recently there has been a large outbreak in Washington State where there has been a 62% increase in cases since a year ago. Rates are high also in Wisconsin and New York.
It is important to speak to your healthcare provider to make sure you are covered. Recently, Katie Rocco, a local dressage coach, received a notice from her mother’s nursing home in Connecticut, asking for authorization to give her mother a Tdap booster. She agreed with alacrity since, several years back, her teenaged daughter contracted whooping cough. At that point, whooping cough had appeared to be quite rare since the initiation of widespread childhood vaccination in the 1950s. “No one diagnosed her correctly until she finally broke a rib coughing,” Ms. Rocco noted. “I definitely wouldn’t want my mother, who’s in her eighties, to have to go through that.”
Because whooping cough is so contagious, it is extra-important to revaccinate adults in places such as nursing homes where residents and staff are in close quarters, and where partly immunized babies and children may be visiting. Valerie Lattrell, RN, nursing director at Noble Horizons, an assisted living community in Salisbury, CT said, “We are offering the Tdap vaccine to residents and employees, and we do have a plan in place for our facility if we were to have cases.”
Whooping cough begins innocently with sneezing, a hacking nighttime cough, tearing and other symptoms of the common cold. Soon the cough is no longer limited to the night, and after about two weeks it reaches the stage at which it is recognizable by a run of 5 to 15 severe, rapid coughs, followed by the “whoop,” a high-pitched, crowing intake of breath. (If you want to hear what whooping cough sounds like in an infant, go to: www.pertussis.com). Vomiting may also occur with severe coughing. Within about four weeks symptoms begin to abate, and the patient will start to feel better. However, coughing may continue for months. If pertussis is recognized and treated early, oral antibiotics may greatly reduce the length of the illness as well as the severity of the cough. Early treatment in infants is especially urgent, and hospitalization may be required.
Since a whooping cough outbreak does seem to be approaching our area, now is the time to call your healthcare provider and ask whether you need to be revaccinated—before you get sick or transmit the disease to others.