There has been an increase in the number of cases of pertussis (whooping cough) in Dane County over the last several months. Pertussis is caused by bacteria called Bordetella pertussis. It affects the lining of the airways causing swelling and narrowing. Its symptoms vary slightly by the age of the person infected. For adolescents and adults, it typically starts like any common cold with nasal congestion, runny nose and/or low-grade fever. There may be intense coughing spells, but these usually don’t occur until later in the illness. What particularly sets pertussis apart from the common cold is the duration of the cough which can last weeks to months and is also given the name of the 100 day cough. For children and some adolescents and adults, the cough can be more intense with a “whoop” sound when they breathe in after a coughing spelling. Vomiting after coughing spells, difficulty breathing and/or blueness to lips and fingers can also occur. In these age groups, pertussis is usually not life-threatening. Infants are more likely to have complications including stopping breathing (apnea), pneumonia and seizures.
The best way to prevent pertussis is through immunization. The immunization for pertussis is given in combination with tetanus and diphtheria. The recommended immunization schedule for DTaP (diphtheria, tetanus and acellular pertussis) is 2 months, 4 months, 6 months, 12-18 months and 4-6 years. Each immunization provides increased protection. This protection wears off with time, so adolescents and adults should be given one booster dose of the vaccine Tdap (tetanus, diphtheria, and acellular pertussis). This is typically given at age 11-12, but has only been available since 2005, so many adults have not received this booster. They may have received a tetanus booster (Td) that contains tetanus and diphtheria, but not pertussis. Even if an adult is not due for a tetanus booster, it is safe to receive the Tdap booster dose sooner. Since infants are especially vulnerable to serious complications of pertussis, it is particularly important for adolescents and adults that are in frequent contact with children under 12 months of age to ensure they are immunized. This decreases the likelihood they will become infected and spread the whooping cough infection to an infant. Meriter and St. Mary’s, as well as other area hospitals, offer mothers the Tdap vaccination after giving birth if they have not had it previously.
Treatment for pertussis is a course of antibiotics. This limits the spread of the infection, but the cough may persist. Like all vaccinations, the pertussis vaccination is not 100 percent effective. If a person was in close contact with someone who is diagnosed with pertussis, prophylactic antibiotics may be needed. If you or your child have a known exposure, it is best to contact your doctor to determine if testing and/or antibiotic treatment are warranted. This is especially important if you or your child have close contact with infants under 1 year of age.
Someone with pertussis or suspected pertussis should stay isolated (avoid contact with others) until they have completed 5 days of treatment or had the cough for 21 days.
Dr. Dana Johnson
Modified from Column originally printed in Wisconsin State Journal on January 19, 2012.