Whooping cough—quick facts

Some time in the mid 1940’s my dad started to cough. Week after week, the cough continued. It interfered with his days, kept him awake at night. He was so fatigued he had to drop out of school. His doctor was stumped. Nothing he tried calmed the cough. Finally, his doctor recommended visiting a warm, dry climate, and my dad and grandmother headed out to California where he enrolled in UCLA.  Meanwhile back in Detroit, my aunt was taking the bus to work, hacking away.  The person sitting next to her said, “You have whooping cough!” When the news reached LA, my dad came back east, began to feel better, and resumed his studies.

When adolescents and adults get whooping cough (pertussis), it’s a substantial annoyance. The cough is unrelenting, often severe enough to cause vomiting, rib fractures, urinary incontinence, and fainting. Once pertussis enters a household, everyone is likely to catch it. If kids under one year old catch it, they will likely land in the hospital and  about 1% die.  Since the development of pertussis vaccination, U.S. rates of the disease are down about 80%. Eradication is theoretically possible, but difficult.

The vaccine is pretty effective, but no completely, and immunity doesn’t last all that long.  Without boosters, kids and adults continue to pass the bacterium around, serving as a disease reservoir. The fewer people who are immune, the more likely an outbreak is to occur. There are still a few things about outbreaks we don’t understand. They occur in a cycle, with the disease numbers jumping up every 3-5 years. What we do know is that during outbreaks, little kids can get very sick and some will die. Infants’ immune systems aren’t able to fight off the infection, and their little bodies can’t handle the toxin pumped out by the bacterium.  They often cough so hard that they stop breathing. The primary reason to vaccinate everyone is to prevent infants from dying. 

Many outbreaks are preventable, and most are easily controlled with good public health surveillance, attentive parents and doctors, and proper vaccination.  Currently, adults (most of whom are no longer immune to pertussis) are advised to get a booster shot.  Most will get the TDaP vaccine, which updates tetanus and diphtheria as well.  This helps reduce the number of adults who can harbor the bacteria, passing it on to our most vulnerable.

Since the vaccine isn’t completely effective, it’s important that as many people as possible get it; this strategy has worked well, decreasing the number of cases and death considerably. When a case is suspected, alert doctors can test for it and treat it, and close contacts can be given prophylactic antibiotics, helping to contain the outbreak.

Last week I received an email from PalKid’s school: a pertussis case had been reported. We weren’t told details, but all cases were apparently treated, and close contacts give antibiotics. The outbreak didn’t take hold. Part of the success was due to the parents. They were straight-forward about it, contacting those who needed to know and following their doctor’s advice. The rest of the success is probably due to our community’s high vaccination rates. I’m pretty happy about this—I don’t think my kid is ready for UCLA.

6 Comments

  1. Barbarella

     /  June 10, 2012

    My great-aunt died of ‘whooping cough’ when she was seventeen, leaving a hole in her close family of rural Wisconsin dairy farmers that never went away until the last of her seven siblings died. In America, so few of us know what it is like to lose a young person to that kind of illness. But it is a reality across the world and all those people are part of our family.

  2. So glad the parents were open about it and vaccination rates are high! I’ve known parents who practice non-disclosure when their kids are ill. We are probably too cautious in the other direction, but I would rather pull my daughter out of preschool for a mild illness than have her be the index case for some awfulness that spreads to younger siblings of her classmates. Of course we’re all up to date on all of our vaccines, so hopefully any potential awfulness we might introduce to the preschool wouldn’t be anything vaccine-preventable.

  3. SES

     /  June 10, 2012

    When adolescents and adults get whooping cough (pertussis), it’s a substantial annoyance. The cough is unrelenting, often severe enough to cause vomiting, rib fractures, urinary incontinence, and fainting.

    Pertussis is known as the “100 day cough” in China.

  4. A. Marina Fournier

     /  June 15, 2012

    “The cough is unrelenting, often severe enough to cause vomiting, rib fractures, urinary incontinence, and fainting.”

    Since I had bronchitis in 1974 or -75, this is my STANDARD cough. I keep water or liquid near me all the time, because if I start to cough, and I don’t start sending the muscles moving downward again, I *will* vomit. I’m not sure when my sister’s fracturing ribs started, but that’s her ordinary cough pattern, when it gets bad enough. I have fainted from ordinary vomiting, but not from coughing that leads to vomiting.

    I’m allergic to codeine/vicodine, so scrip cough remedies are out for me when I have a germy cough, as opposed to an allergy or reactive one.

    This March, either my allergies were the worst they’ve ever been (much like the pollen count), or I had a bug that, unlike my husband’s, didn’t have any fever or other symptoms. They were the worst sounding coughs I’ve ever had, to the point where I wondered, three weeks out, whether I might have whooping cough or walking pneumonia. There was an odd high-octave wheeze to them I’d never heard, and even sleeping at a 45˚ angle didn’t allow me to sleep for more than about 30 min. at a time, if that.

    Given that those particular cough patterns have gone away, I’ll go with allergies. I do keep up my boosters, btw.

  5. Kurt Kemmerer

     /  June 15, 2012

    Alas, this story has been repeated across the country this Spring, including at my kid’s school here in Portland, OR.

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