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Pertussis, The 100-Day Cough

by on February 08, 2015 6:00 AM

Until recently, many people thought of pertussis -- also known as whooping cough -- as a disease of the past.

Others thought the immunizations they received in childhood would protect them for life.

But, recent reports of pertussis in our community have caused many to think again about this "old" disease.

I must confess, even though I'm a fairly "seasoned" healthcare worker (30+ years working in hospitals), I have rarely seen a case of pertussis, and just recently witnessed a coughing spell caused by this highly contagious infection. It was very impressive.

What are the symptoms of pertussis?

Pertussis is a bacterial infection of the respiratory system, characterized by severe coughing spells (paroxysms) that may end in a "whooping" sound when the person breathes in. The characteristic "whoop" or crowing sound is often absent in infants less than six months of age, adolescents and adults.

Other symptoms of pertussis include runny nose, sneezing, a low-grade fever, and vomiting at the end of the coughing spell. The coughing spells can be severe and may leave the person exhausted. The disease has sometimes been referred to as the "100 day cough" because the cough can continue for weeks. If you're curious and would like to hear the pertussis cough, visit www.pertussis.com to listen to an audio clip.

Is pertussis a re-emerging disease?

Before a vaccine became available, pertussis was one of the most common childhood diseases and a major cause of death in children in the United States. Pertussis killed up to 10,000 people each year. After introduction of the vaccine in the 1940s, the disease dropped off dramatically.

In the 1980s the number of cases reported each year began to rise again and several major outbreaks have occurred. Most cases are in unvaccinated or incompletely vaccinated infants but almost all adults and teens are susceptible to the disease. This would suggest that protection from the vaccine may be decreasing over time. If you had the disease as a child and think you're protected, think again. Even if you've had the disease, you may not have life-long immunity.

How serious is pertussis?

Although pertussis can occur at any age, it is most severe in infants who have not been immunized. These children can have life-threatening illness and commonly require hospitalization. Older immunized children or adults with pertussis often have milder symptoms that can resemble a simple cold.

What can be done to prevent the spread of pertussis?

The best way to reduce the risk of complications from whooping cough is to make sure children are fully immunized. Children receive a combined vaccine at two, four, six, 12-19 months of age, and between four and six years of age. It is also important to avoid exposing unimmunized infants to persons with cough-illness. A pertussis-containing vaccine, referred to as Tdap, can protect adolescents and adults. One dose of Tdap is routinely given at age 11 or 12 but people who did not get Tdap at that age should get it as soon as possible.

What should you do if you develop a cough?

  • In the absence of known cases of pertussis in the community, consult your physician for cough-illnesses lasting longer than two weeks or sooner if accompanied by other symptoms, or you have other conditions that make you at high-risk of complications from respiratory infections.
  • Close contacts of persons diagnosed with pertussis should receive preventive antibiotics even if they have no symptoms. If symptoms develop, they should stay home from school or work until five days of antibiotics have been completed.
  • In the presence of known cases of pertussis in the community, consult a physician as soon as possible if cough and other symptoms suggestive of pertussis develop. Your physician may order some tests, prescribe an antibiotic, and recommend that you stay home from school or work until five days of antibiotics have been completed.

If you would like more information about pertussis, visit the Centers for Disease Control and Prevention website at www.cdc.gov or contact the local health department.



Marlene Stetson is the director of infection prevention and control at Mount Nittany Medical Center.
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