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Pertussis (Whooping Cough)
What is whooping cough?
Whooping cough or pertussis, is an easily spread disease caused by the bacterium Bordetella pertussis. Whooping cough was common in the past. It caused frequent epidemics and a lot of childhood deaths. However, after a whooping cough vaccine was made, the number of cases dropped from over 200,000 per year in the 1940s, to less than 3,000 cases per year in the 1980's.
Recently, however, pertussis has been on the rise (read more about pertussis in California and San Francisco). A whooping cough epidemic was declared in California in June 2010 because many more people have been getting whooping cough in 2010 compared to previous years. There have also been more deaths from whooping cough. All deaths have been in children less than a year old.
Although people of all ages can get whooping cough, young infants are at highest risk for having severe disease and problems from whooping cough. Most infants under 6 months of age need to be in the hospital. However, despite advanced medical care many of these infants will have problems. The most common complication, and the cause of most whooping cough deaths, is pneumonia. Other complications are seizures and brain damage.
How does whooping cough spread?
The bacteria that cause whooping cough live in the mouth, nose and throat of an infected person. Whooping cough is spread through tiny wet drops produced when an infected person coughs, sneezes or talks. Infected people usually spread whooping cough during the first 2-3 weeks of infection: from the time the runny nose begins until 3 weeks after the coughing spells start. If an infected person takes the right antibiotics for 5 days they will no longer be able to spread the disease.
Sometimes people with mild disease spread whooping cough because they continue with their regular activities, do not see a doctor and do not get treated. Recent outbreaks have shown that older children, adolescents, and adults, including parents, spread whooping cough because when they get sick they don't feel very ill but are still contagious.
People who have whooping cough should receive treatment and should avoid close contact with all persons, especially young children and pregnant women, during the first 5 days of their antibiotic treatment.
How can I protect myself and my family from getting sick with whooping cough?
Vaccine
The best way to protect yourself and your family from getting sick with whooping cough is to get the whooping cough vaccine. Vaccination for whooping cough should start early in infancy and continue through childhood with the DTaP (diphtheria, tetanus, acellular pertussis) vaccine. Because the vaccine wears off over time, vaccination should continue into adolescence and adulthood with the Tdap (tetanus, diphtheria, acellular pertussis) vaccine.
- All adolescents and adults should receive the whooping cough vaccine (Tdap). We recommend that everyone be up-to-date with the whooping cough vaccine, especially if you have close contact to infants or pregnant women.
- Pregnant women should receive the whooping cough vaccine (Tdap) either during pregnancy or immediately after birth. The whooping cough vaccine is considered safe during pregnancy.
- Although the vaccine is licensed for those under age 65, we recommend that adults age 65 and older receive one whooping cough vaccine (Tdap). This is especially important for those adults 65 and older who are around an infant.
- There is no minimum interval between the last tetanus vaccine (Td) and the whooping cough vaccine (Tdap).
- Talk to your doctor to see if you should get the whooping cough vaccine.
Please click here to learn more about vaccine and where you can get vaccinated.
Prevention
It is important for some of the people who have had close contact to infected persons to receive antibiotic medication to prevent infection:
- Infants <1 year old
- Pregnant women in their 3rd trimester
- People who have close contact with pregnant women and infants (including certain health care workers)
If you know that you or family members have been exposed to whooping cough, contact your doctor. Close contact is defined as sharing toys, food, or utensils, face-to-face contact, direct exposure to cough, sneeze, or secretions, or sharing a confined space for over one hour.
Healthy Habits
All people should practice healthy habits by washing hands often, covering coughs and staying home when sick. Click here to learn more about healthy habits.
What are the symptoms and signs of whooping cough?
Whooping cough has 3 stages:
- In the first stage there is runny nose, sneezing, low-grade fever, and a mild cough that gets worse over a period of 1-2 weeks.
- During the second stage the patient has bursts or attacks of cough. At the end of each burst, there can be a high-pitched "whoop" sound. For an example of the sound click here. This can be a dangerous stage for infants and young children. During coughing attacks they may turn blue, and appear very ill or look like they are having difficulty breathing. Vomiting and tiredness can follow these cough episodes. This stage usually lasts 1-6 weeks.
- In the third stage the cough slowly disappears over 2-3 weeks. Many people will have coughing attacks with later colds or other infections.
The whooping cough vaccine is very good but not 100% effective and its protection wears off over time. Also people who have had whooping cough can get it again. Sometimes people who have been vaccinated or had the illness before have whooping cough symptoms that are different (not as severe) as what is described above. It is important to think about the possibility of whooping cough even in people that have been vaccinated or had the illness before.
If you think that you have whooping cough you should contact your doctor.
How is whooping cough treated?
Antibiotics are most helpful if started during the first stage of the disease. When taken early antibiotics can help improve symptoms. If taken later, but still during the first three weeks of illness, antibiotics may not help with symptoms but will help stop the spread of disease by making the infected person less contagious (click here for dosing guidelines).
Useful Pertussis Links