Pertussis: Big whoop or not?

This winter has seen the worst outbreak of whooping cough since 1955, according to reports.

My child has had a severe cough for the past few days — could it possibly be whooping cough? Can children still contract the disease?

To start, you need to confirm whether your child has been immunized against pertussis (whooping cough). Childhood immunizations have been largely responsible for severely curtailing outbreaks of many diseases, including pertussis, since the diphtheria-tetanus-pertussis vaccine is often part of a regular pediatric immunization schedule.

It is unclear why this winter has seen such a spike in whooping cough cases, and indeed, concerns are starting to arise as to the duration of the pertussis vaccine’s efficacy. Those questions aside, should your child come down with the symptoms of pertussis, you should still seek treatment right away.

Caused by bacteria called bordetella pertussis, pertussis is an inflammation of the respiratory tract. The disease is highly contagious, and commonly affects young children between 1 and 10 years old. At first, the symptoms of whooping cough are fairly mild, and can include a runny nose, congestion, low fever, and mild cough. Those symptoms may eventually become severe enough to cause spasms of coughing — often four or five hard, repeated coughs — followed by a “whooping” sound that results from the infected child gasping for air. Left untreated, the nasal and respiratory tract congestion can lead to pneumonia. Pertussis commonly affects older children or teens who may not have been immunized. Pertussis can also affect adults whose childhood immunizations have worn off.

During its early stages, pertussis can be treated with the antibiotic erythromycin, which can sometimes prevent the disease from worsening. However, once pertussis progresses to include severe coughing spasms, antibiotics may no longer be effective. Physicians sometimes recommend hospitalization for children with pertussis, especially for infants under six months of age. With proper care, regular hydration, and suction to clear blocked nasal passages, the coughing spasms should eventually subside.

Whooping cough can usually be prevented with a series of regular immunizations, so whether or not your child has already had whooping cough, it is important to make sure he still gets immunized. When someone gets pertussis, his body develops a natural immunity to the disease. However, the duration of that immunity varies from person to person, so routine vaccinations against whooping cough are recommended.

Make sure you discuss any questions you have about pertussis treatment or the vaccine with your child’s pediatrician. Proper caution will go a long way in ensuring that pertussis remains no big whoop.

Dr. Pramod Narula is chairman of the Department of Pediatrics at New York Methodist Hospital.