Whooping Cough: A Comprehensive Overview

Whooping cough, also known as pertussis, is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. It primarily affects the lungs and breathing tubes, leading to severe coughing fits.

Whooping Cough

Source: Purla Journal Star

Why is it called “Whooping Cough”?

The name “whooping cough” comes from the distinctive “whoop” sound made when a person gasps for air after a coughing fit. This sound is more common in children but can occur in adults as well.

Why is Whooping Cough called the “100-Day Cough”?

Whooping cough is sometimes referred to as the “100-day cough” because the severe coughing fits can last for weeks or even months, often up to 10 weeks or more. This prolonged duration of coughing is a hallmark of the disease, making it particularly challenging and exhausting for those affected

Why is whooping cough called ‘Tosferina’?

The term “Tosferina” is the Spanish name for whooping cough. It comes from the Spanish words “tos” meaning “cough” and “ferina” meaning “ferocious” or “severe.” This name reflects the characteristic severe coughing fits associated with the disease

What is the pattern of Whooping Cough Outbreaks?

Whooping cough outbreaks occur periodically and can be particularly severe in areas with low vaccination rates. Here are some key points about recent outbreaks:

1. Wisconsin Outbreak: Recently, Wisconsin has seen a significant rise in whooping cough cases, with over 220 reported cases this year. This increase signals a return to pre-pandemic levels of the infection.
2. General Trends: Whooping cough is an endemic disease in the United States, with peaks in reported cases every few years. The COVID-19 pandemic temporarily reduced transmission due to mitigation measures like masking and remote learning, but cases are now returning to typical patterns.
3. Unvaccinated Populations: Outbreaks are more common in areas with large pools of unvaccinated individuals. For example, a recent surge in whooping cough cases has been observed among unvaccinated children.
4. Public Health Response: During outbreaks, public health authorities focus on protecting those at highest risk of serious illness. Strategies include vaccination, preventive antibiotics, and active screening in common settings like schools and childcare centers.
5. Global Perspective: While the United States experiences periodic outbreaks, whooping cough remains a global health concern. Efforts to increase vaccination coverage are crucial in preventing future outbreaks and protecting vulnerable populations

What measures can individuals take during a whooping cough outbreak?

During a whooping cough outbreak, individuals can take several measures to protect themselves and others. Here are some key steps:

1. Vaccination:
   • Get Vaccinated: Ensure you and your family are up-to-date with the pertussis vaccine (DTaP for children and Tdap for adolescents and adults). Vaccination is the most effective way to prevent whooping cough.
   • Pregnant Women: Pregnant women should receive the Tdap vaccine between the 27th and 36th week of pregnancy to protect their newborns.
2. Hygiene Practices:
   • Handwashing: Wash hands regularly with soap and water, especially after coughing or sneezing.
   • Cover Coughs and Sneezes: Use a tissue or your elbow to cover your mouth and nose when coughing or sneezing to prevent the spread of respiratory droplets.
   • Avoid Sharing Personal Items: Do not share utensils, drinking cups, or other personal items.
3. Avoid Close Contact:
   • Stay Away from Infected Individuals: Avoid close contact with people who have symptoms of whooping cough.
   • Isolate if Infected: If you or your child has whooping cough, stay home and avoid public places to prevent spreading the infection.
4. Seek Medical Attention:
   • Early Diagnosis and Treatment: If you suspect you or your child has whooping cough, seek medical attention promptly. Early diagnosis and treatment with antibiotics can reduce the severity and duration of the illness.
5. Preventive Antibiotics:
   • Postexposure Prophylaxis: In some cases, healthcare providers may recommend preventive antibiotics for close contacts of someone with whooping cough to prevent the spread of the disease

What are the symptoms of whooping cough?

Whooping Cough

Source: YouTube JJMedicine

1. Whooping cough, also known as pertussis, progresses through several stages, each with distinct symptoms. Here are the key symptoms to look out for:Early Symptoms (Catarrhal Stage)
   1. Runny Nose: Often the first sign, resembling a common cold.Nasal Congestion: Accompanied by a runny nose.Red, Watery Eyes: Common in the initial stages. Mild Fever: Low-grade fever is typical .Mild Cough: Starts as a mild, persistent cough.
   Later Symptoms (Paroxysmal Stage)
   1. Severe Coughing Fits: Characterized by rapid, violent coughing followed by a high-pitched “whoop” sound as the person breathes in .Thick Mucus: Accumulation of thick mucus in the airways .Vomiting: Coughing fits can be so severe that they induce vomiting .Exhaustion: Extreme tiredness after coughing fits .Red or Blue Face: Due to the intensity of the coughing.
   Symptoms in Infants
   • Apnea: Infants may not cough at all but may struggle to breathe or temporarily stop breathing.
   When to See a Doctor
   • Prolonged Coughing Spells: If coughing spells cause vomiting, turn the face red or blue, or cause noticeable pauses in breathing. Whooping Sound: If you hear the characteristic “whoop” sound during breathing.
   Early detection and treatment are crucial for managing whooping cough effectively. If you or someone you know exhibits these symptoms, it’s important to seek medical attention promptly.

How is whooping cough diagnosed?

Diagnosing whooping cough, or pertussis, can be challenging, especially in its early stages, as its symptoms often resemble those of other common respiratory illnesses like the cold, flu, or bronchitis. Here are the primary methods used for diagnosis:

1. Medical History and Physical Examination:
   • Symptom Assessment: Doctors will ask about symptoms and listen to the characteristic “whoop” sound during coughing fits.
   • Physical Exam: A thorough physical examination helps identify signs of whooping cough.
2. Laboratory Tests:
   • Nose or Throat Culture and Test: A swab or suction sample is taken from the nasopharynx (the area where the nose and throat meet) and tested for the presence of Bordetella pertussis bacteria.
   • Blood Tests: A blood sample may be drawn to check the white blood cell count, which can indicate infection or inflammation. This test is general and not specific to whooping cough.
3. Imaging:
   • Chest X-ray: An X-ray may be ordered to check for inflammation or fluid in the lungs, which can occur when pneumonia complicates whooping cough and other respiratory infections.

Additional Diagnostic Considerations

• Timing: Early diagnosis is crucial for effective treatment and preventing the spread of the disease.
• Infants and Young Children: Special attention is given to infants and young children, as they are at higher risk for severe complications.

If you suspect you or someone you know has whooping cough, it’s important to seek medical attention promptly for accurate diagnosis and appropriate treatment.

What are the complications of Whooping Cough?

Whooping cough, or pertussis, can lead to several complications, especially in infants and young children. Here are some of the key complications:

Complications in Infants and Young Children

1. Pneumonia: A common and serious complication where the lungs become infected.
2. Dehydration and Weight Loss: Severe coughing fits can make it difficult for infants to eat or drink, leading to dehydration and weight loss.
3. Apnea: Infants may experience pauses in breathing, which can be life-threatening.
4. Seizures: High fever and severe coughing can sometimes lead to seizures.
5. Brain Damage: Prolonged lack of oxygen during severe coughing fits can cause brain damage.

Complications in Teens and Adults

1. Bruised or Cracked Ribs: Intense coughing can lead to bruised or even cracked ribs.
2. Abdominal Hernias: The strain from severe coughing can cause hernias.
3. Broken Blood Vessels: Coughing fits can cause small blood vessels in the skin or the whites of the eyes to break.

General Complications

1. Extreme Fatigue: The prolonged coughing fits can lead to significant exhaustion.
2. Vomiting: Severe coughing can induce vomiting.
3. Respiratory Arrest: In severe cases, the person may stop breathing temporarily.

Long-Term Impact

• Chronic Cough: Some individuals may experience a persistent cough that lasts for weeks or even months after the initial infection.
• Secondary Infections: The weakened immune system can make individuals more susceptible to other infections.

Prevention and Management

• Vaccination: The best way to prevent whooping cough and its complications is through vaccination (DTaP for children and Tdap for adolescents and adults)
• Early Treatment: Prompt medical attention and antibiotic treatment can help reduce the severity of the disease and prevent complication.

What are the Treatments of Whooping Cough?

Whooping cough, also known as pertussis, is a highly contagious respiratory infection. Here are the common treatments:

Medications

• Antibiotics: These are used to kill the bacteria causing the infection and to help speed up recovery. Early treatment is crucial to make the illness less severe and to prevent spreading it to others.
• Preventive Antibiotics: Family members and close contacts may also be given antibiotics to prevent them from getting infected.

Home Care

• Rest: Ensure plenty of rest in a cool, quiet, and dark environment to help with relaxation and recovery.
• Fluids: Drink plenty of fluids like water, juice, and soups to stay hydrated.
• Small Meals: Eating smaller, more frequent meals can help prevent vomiting after coughing.
• Clean Air: Keep the air clean by avoiding irritants like tobacco smoke and fumes.

Hospital Care

• Infants and Severe Cases: Infants and those with severe symptoms may need hospitalization for monitoring, oxygen support, and intravenous fluids to prevent dehydration.

Self-Care Tips

• Humidifiers: Using a cool-mist humidifier can help moisten the airways and soothe the cough.
• Avoid Cough Medicines: Over-the-counter cough medicines are generally not effective and are discouraged.

Prevention

• Vaccination: The best way to prevent whooping cough is through vaccination

What are the antibiotics to treat Whooping Cough?

The antibiotics commonly prescribed to treat whooping cough (pertussis) include:

• Azithromycin
• Clarithromycin
• Erythromycin
• Trimethoprim-sulfamethoxazole (as an alternative to macrolides) 

These antibiotics are most effective when administered early in the course of the illness. They help reduce the severity of symptoms and prevent the spread of the infection to others. 

What are the side effects of these antibiotics?

Here are the common side effects for each of the antibiotics used to treat whooping cough:

Azithromycin

• Common: Diarrhea, nausea, abdominal pain, vomiting.
• Less Common: Headache, dizziness.
• Rare: Blistering, peeling, or loosening of the skin, bloody or cloudy urine.

Clarithromycin

• Common: Nausea, vomiting, taste perversion, abdominal pain, diarrhea.
• Less Common: Rash, flatulence, headache, constipation, hearing disturbance.
• Rare: Increased liver enzymes (AST, ALT).

Erythromycin

• Common: Nausea, vomiting, abdominal pain, diarrhea.
• Less Common: Loss of appetite, rash.
• Rare: Liver toxicity, hearing loss.

Trimethoprim-sulfamethoxazole

• Common: Nausea, vomiting, rash.
• Less Common: Diarrhea, loss of appetite.
• Rare: Severe skin reactions, blood disorders.

If you experience any severe or unusual side effects, it’s important to contact your healthcare provider immediately.

How can I manage these side effects?

Managing the side effects of antibiotics can help make your treatment more comfortable. Here are some strategies:

General Tips

1. Follow Instructions: Always take antibiotics exactly as prescribed. Some should be taken with food to reduce stomach upset, while others should be taken on an empty stomach.
2. Stay Hydrated: Drink plenty of water to help manage gastrointestinal side effects like diarrhea and nausea
3. Probiotics: Taking probiotics or eating probiotic-rich foods like yogurt can help maintain the balance of good bacteria in your gut.
4. Avoid Alcohol: Alcohol can exacerbate side effects like nausea and dizziness. Some antibiotics can cause severe reactions when combined with alcohol.
5. Rest: Ensure you get plenty of rest to help your body recover.

Specific Side Effects

• Nausea and Vomiting: Eat small, frequent meals and avoid rich, spicy, or fatty foods.
• Diarrhea: Increase your fiber intake and consider taking probiotics.
• Photosensitivity: Avoid direct sunlight and use sunscreen to protect your skin.
• Headaches: Over-the-counter pain relievers like acetaminophen or ibuprofen can help.

When to Seek Medical Help

• Severe Reactions: If you experience severe side effects like persistent diarrhea, severe rash, or difficulty breathing, contact your healthcare provider immediately.
• Allergic Reactions: Symptoms like swelling of the lips or tongue, shortness of breath, or severe rash require immediate medical attention

How long should I take antibiotics to treat whooping cough?

The duration of antibiotic treatment for whooping cough (pertussis) typically depends on the specific antibiotic prescribed:

Azithromycin

• Adults and children: Usually taken for 5 days.

Clarithromycin

• Adults and children: Typically taken for 7 days.

Erythromycin

• Adults and children: Generally taken for 7 to 14 days.

Trimethoprim-sulfamethoxazole

• Adults and children: Usually taken for 14 days.

It’s important to follow your healthcare provider’s instructions precisely and complete the full course of antibiotics, even if you start feeling better before finishing the medication. This helps ensure that the infection is fully eradicated and reduces the risk of developing antibiotic-resistant bacteria.

Can a pregnant woman take Whooping cough vaccine?

Yes, pregnant women are recommended to receive the whooping cough vaccine, specifically the Tdap vaccine, during each pregnancy. The ideal time to get the vaccine is between the 27th and 36th weeks of pregnancy.

Benefits

• Protection for the Baby: The vaccine helps the mother produce antibodies that are passed to the baby, providing protection against whooping cough in the first few months of life.
• Reduced Risk: Getting the Tdap vaccine during pregnancy significantly lowers the risk of whooping cough in babies younger than 2 months old.

Safety

• Proven Safe: The Tdap vaccine has been shown to be safe for both the mother and the baby.
• No Live Bacteria: The vaccine does not contain live bacteria, so it cannot cause whooping cough.

Timing

• Optimal Timing: The best time to get the vaccine is early in the third trimester to ensure the highest level of antibodies are passed to the baby

How effective is the Tdap vaccine in preventing whooping cough?

The Tdap vaccine is highly effective in preventing whooping cough (pertussis). Here are some key points about its effectiveness:

Effectiveness

• Adults and Adolescents: The Tdap vaccine is about 70-90% effective in preventing whooping cough in the first year after vaccination.
• Pregnant Women: When given during pregnancy, the Tdap vaccine is highly effective in protecting newborns from whooping cough in their first few months of life.
• Duration: The effectiveness of the vaccine decreases over time, which is why booster shots are recommended every 10 years.

Benefits

• Community Protection: By reducing the number of people who can get and spread whooping cough, the vaccine helps protect those who are most vulnerable, such as infants and those with weakened immune systems.
• Reduced Severity: Even if a vaccinated person contracts whooping cough, the symptoms are usually less severe than in those who are unvaccinated.

Recommendations

• Pregnant Women: The CDC recommends that pregnant women receive the Tdap vaccine during each pregnancy, ideally between the 27th and 36th weeks.
• General Population: It’s recommended for all adults who have never received it and as a booster every 10 years

How long does immunity from the Tdap vaccine last?

Immunity from the Tdap vaccine typically lasts about 10 years. After this period, a booster shot is recommended to maintain protection against tetanus, diphtheria, and pertussis (whooping cough).

Booster Recommendations

• Adults: A booster dose of either Tdap or Td (which protects against tetanus and diphtheria but not pertussis) is recommended every 10 years.
• Special Cases: If you have a severe or dirty wound, a booster may be recommended if it’s been more than 5 years since your last dose.

Pregnancy

• Pregnant Women: It’s recommended to receive the Tdap vaccine during each pregnancy, ideally between the 27th and 36th weeks, to protect the newborn from whooping cough

What are the side effects of the Tdap booster shot?

The Tdap booster shot is generally safe, but like all vaccines, it can cause some side effects. Here are the most common ones:

Common Side Effects

• Pain, Redness, or Swelling: At the injection site.
• Mild Fever: A slight increase in body temperature.
• Headache: Mild to moderate headaches.
• Fatigue: Feeling tired or fatigued.
• Nausea and Vomiting: Some people may experience stomach upset.
• Diarrhea: Mild gastrointestinal discomfort.

Less Common Side Effects

• Fainting: Some preteens and teens might faint after getting the shot.
• Loss of Appetite: Temporary decrease in appetite.

Rare Side Effects

• Severe Allergic Reactions: Though very rare, symptoms like difficulty breathing, swelling of the face and throat, and a fast heartbeat require immediate medical attention

How effective is DTaP in combating Whooping Cough?

The DTaP vaccine is highly effective in combating whooping cough (pertussis), especially in children. Here are some key points about its effectiveness:

Effectiveness in Children

• Initial Protection: The DTaP vaccine protects about 98 out of 100 children within the first year after completing the five-dose series.
• Long-Term Protection: About 7 out of 10 children remain protected five years after the last dose.

Booster Shots

• Preteens and Teens: A booster shot (Tdap) is recommended between the ages of 11 and 12 to maintain immunity.
• Adults: Adults should receive a Tdap booster every 10 years to ensure continued protection.

Community Impact

• Herd Immunity: High vaccination rates help protect those who cannot be vaccinated, such as infants and individuals with certain medical conditions.

The DTaP vaccine is a crucial tool in preventing whooping cough and its complications.

Is there a difference between DTaP and Tdap vaccines?

Yes, there are key differences between the DTaP and Tdap vaccines:

DTaP Vaccine

• Target Group: Given to infants and children under 7 years old.
• Dosage: Contains full-strength doses of diphtheria, tetanus, and pertussis vaccines.
• Schedule: Administered in a series of five shots at 2, 4, and 6 months, between 15 and 18 months, and between 4 and 6 years.

Tdap Vaccine

• Target Group: Given to older children (starting at age 11 or 12), adults, and pregnant women.
• Dosage: Contains lower doses of diphtheria and pertussis vaccines compared to DTaP, but a full-strength dose of the tetanus vaccine.
• Booster: Used as a booster shot to maintain immunity, recommended every 10 years.

Usage During Pregnancy

• Tdap: Recommended for pregnant women between 27 and 36 weeks of each pregnancy to protect the newborn from whooping cough.

Both vaccines protect against the same diseases (diphtheria, tetanus, and pertussis), but they are used at different stages of life and have different dosages to suit the needs of the specific age groups

Is there a difference in effectiveness between DTaP and Tdap?

Both the DTaP and Tdap vaccines are highly effective in preventing whooping cough (pertussis), but they serve different purposes and are used in different age groups.

Effectiveness

• DTaP Vaccine:
  • Children: Provides about 98% protection within the first year after completing the five-dose series.
  • Long-Term: About 70% of children remain protected five years after the last dose.
• Tdap Vaccine:
  • Adolescents and Adults: Provides about 70% protection in the first year after vaccination.
  • Booster: Used to maintain immunity, with effectiveness decreasing over time, which is why a booster is recommended every 10 years.

Purpose and Dosage

• DTaP: Contains full-strength doses of diphtheria, tetanus, and pertussis vaccines and is given to infants and children under 7 years old.
• Tdap: Contains lower doses of diphtheria and pertussis vaccines (but a full-strength dose of tetanus) and is used as a booster for older children, adolescents, and adults.

Both vaccines are crucial in maintaining immunity against these diseases, with DTaP building initial immunity in young children and Tdap boosting and maintaining that immunity in older children and adults

Can you get whooping cough if vaccinated?

Yes, it is possible to get whooping cough (pertussis) even if you are vaccinated, but the chances are significantly reduced. Here are some key points:

Reduced Risk

• High Effectiveness: The DTaP and Tdap vaccines are highly effective, but not 100%. They greatly reduce the risk of getting whooping cough.
• Milder Symptoms: If a vaccinated person does contract whooping cough, the symptoms are usually less severe and the duration of the illness is shorter compared to those who are unvaccinated.

Waning Immunity

• Over Time: The immunity provided by the vaccines decreases over time, which is why booster shots (Tdap) are recommended every 10 years.
• Booster Importance: Regular boosters help maintain immunity and protect against the disease.

Community Protection

• Herd Immunity: High vaccination rates help protect those who cannot be vaccinated, such as infants and individuals with certain medical conditions.

Vaccination remains the best way to protect yourself and others from whooping cough.

How does Pertussis affect in Adults?

Whooping cough (pertussis) can affect adults in several ways, and while it is often less severe than in infants and young children, it can still cause significant discomfort and complications. Here are some key points:

Symptoms in Adults

• Persistent Cough: A prolonged, severe cough that can last for weeks or even months.
• Whooping Sound: The characteristic “whoop” sound when inhaling after a coughing fit, although this may not always be present in adults.
• Runny Nose and Nasal Congestion: Similar to cold symptoms at the beginning.
• Sneezing and Mild Fever: Common early symptoms.
• Fatigue: Extreme tiredness due to the persistent coughing.

Complications

• Weight Loss: Due to the effort of coughing and reduced appetite.
• Urinary Incontinence: Coughing fits can lead to loss of bladder control.
• Rib Fractures: Severe coughing can cause rib fractures.
• Pneumonia: Increased risk of secondary infections like pneumonia.
• Sleep Disturbances: Difficulty sleeping due to frequent coughing.

Impact on Daily Life

• Work and Social Life: The persistent cough and fatigue can interfere with daily activities, work, and social interactions.
• Increased Risk for Vulnerable Groups: Adults with underlying conditions like asthma or COPD are at higher risk for complications.

Prevention

• Vaccination: The best way to prevent whooping cough is through vaccination. Adults should receive a Tdap booster every 10 years

How can adults check their vaccination status for Tdap?

Adults can check their vaccination status for the Tdap vaccine through several methods:

1. Medical Records

• Doctor’s Office: Contact your primary care provider or the clinic where you usually receive vaccinations. They should have a record of your immunizations.
• Pharmacy: If you received the vaccine at a pharmacy, they should also have a record.

2. Immunization Information Systems (IIS)

• State or Local IIS: Many regions have immunization registries that keep track of vaccinations. You can contact your local health department to access these records.

3. Personal Health Records

• Digital Records: Use any personal health record apps or portals provided by your healthcare provider. Many electronic health records (EHR) systems allow patients to view their vaccination history online.
• Paper Records: Keep a personal record of your vaccinations. If you have a vaccination card or booklet, it should include the date and type of vaccines received.

4. Vaccine Finder Tools

• Online Tools: Websites like the Adult Vaccine Finder can help you locate places that provide Tdap and other vaccines.

5. Ask Your Healthcare Provider

• Consultation: If you’re unsure about your vaccination status, your healthcare provider can help determine if you need a booster shot based on your medical history and current guidelines