Friday, November 16, 2012

Problems That Threaten Whooping Cough

Whooping cough is making a comeback. The good news is that it can be prevented and treated when it's caught early. According to, "Whooping cough is a contagious bacterial disease chiefly affecting children and characterized by convulsive coughs followed by a whoop."

This vaccine for whooping cough is normally given in five increments, given to children at 2, 4 and 6 months of age; then again between 15 and 18 months and the last dose is given between 4 and 6.

The "whooping" sound is the noise a person's voice box makes when they can take a breath again after the coughing subsides.

Whooping Cough

Whooping cough is more severe than an ordinary cough and early on it can be difficult to tell the difference between the two, says Dr. Richard Krieger, chairman of the Infection Control Committee at Chilton Hospital.

"In the first one to two weeks of the illness, it can look like a common cold," Krieger says, explaining, "Unless there is a history of exposure to a family member or other close contact with whooping cough, it is very hard to differentiate at this point. When the cough develops, it generally occurs as severe paroxysms (sudden attacks) which can be followed by characteristic "whoop" (typically in children 6 months to 5 years old) on inhalation after a coughing spell. If a cough lasts over 14 days in the setting of an outbreak, that raises suspicion.

"There are lab tests that can identify the infection or the bacteria (bordetella pertussis) can be identified on culture of respiratory secretions, but these tests will not give an immediate diagnosis, as it may take days to get the results," Krieger says. "Generally, x-rays are not helpful.

"Whooping cough is very contagious. Up to 80 to 90 percent of susceptible persons who are exposed to it will develop the infection," states Krieger.

The good news is that whooping cough is preventable. According to the Centers for Disease Control and Prevention's website (, the United States has seen more than 32,000 cases and 16 deaths from whooping cough in recent years.

The CDC recommends that the best way to prevent whooping cough in children is to immunize them with the vaccine DTap (diphtheria, tetanus and pertussis). This vaccine is normally given in five increments, the first three doses given to children at 2, 4 and 6 months of age; the fourth dose between 15 and 18 months; and, the last dose between 4 to 6 years old. Adults and children 11 – 12 years of age should have the Tdap booster for continued prevention.

Krieger concurs wit the CDC guidelines and recommends that adults receive booster shots every 10 years, whether it is given in conjunction with a tetanus shot or not.

"A few years ago, the state of New Jersey made it a requirement for children entering middle school to receive the Tdap booster before sixth grade," says Donna Dericks, school nurse at Hillview Elementary School in Pompton Plains. "Fortunately, I've only seen maybe two cases of whooping cough in the past five years."

If someone does contract whooping cough, Krieger says that "antibiotic therapy, such as Erythromycin or Clarithromycin, will help if given early in the course of the infection. However, usually by the time the characteristic cough develops it is too late to have an effect on the course of the illness, though it can at least decrease the period of contagiousness.

"In the general population, there has been a rise in whooping cough cases in recent years. Adults generally don't get too sick from whooping cough that they can't function. Healthy older children won't get disabled from the cough, but they do tend to spread it. Whooping cough is much more serious in young children. Immunization is the way to go to prevent whooping cough."

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