According to the New York State Department of Health, the number of cases of pertussis, or whooping cough, is on the rise. Figures show 970 cases reported so far in 2012 compared with only 931 in all of 2011. The Centers for Disease Control and Prevention reported that the number of cases in the U.S. through June 4 was nearly 44 percent higher than the number reported in the same period the prior year.
We spoke with Melissa Stockwell, M.D., MPDH, medical director of the NewYork-Presbyterian Hospital/Columbia University Medical Center Immunization Registry, to find out what parents should know about pertussis, including symptoms, how it spreads, vaccinations available, and what to do when your child has whooping cough.
What is pertussis and is it contagious?
Pertussis is caused by a bacterial respiratory infection. People who get pertussis often have very severe coughing spells, which, for children with pertussis, can cause them to turn red or purple. The reason why it is called whooping cough is that, sometimes, at the end of those coughing spells, the first intake is a very forceful breath that results in a whooping sound. Often, though, those infected don’t get the whooping sound. You can still have pertussis and not get the sound.
Whooping cough is very contagious in the way it spreads—through tiny droplets filled with infected fluid. Basically, when somebody infected sneezes, coughs, or laughs, [this infected fluid] comes out. Other people become infected by inhaling those drops or by getting it on their hands and/or near their mouths or noses. Many of the young infants who become infected got infected from someone in the household such as a parent, sibling, or caregiver who didn’t even know that they had the disease.
What age group can be infected by pertussis?
It can affect anybody at any age, but it is particularly dangerous for young children under 6 months because this is when the infection can be life threatening. These coughing spells can…lead young children to stop breathing. Children under 6 months can also get very severe pneumonia. The issue is that children who are of this age, who are not fully vaccinated against the disease, can be treated by antibiotics—which helps them to become not contagious but does not relieve them of their symptoms except in some cases when treated very early. Often during this time, parents just have to wait it out, but during that time the kids can get very sick. It is important to understand that more than half the infants who get pertussis will be hospitalized. Additionally, 25 percent of those less than 1 year of age can get pneumonia.
For adults and teens, pertussis can be a milder infection. They may or may not get the whoop, and they won’t necessarily get sick from it. They may just have a prolonged cough. They can, however, infect others.
Why has the number of pertussis cases increased in the last few years?
There are a lot of factors involved. One of them is waning immunity for adults, and that is why there is actually a pertussis booster for adolescents. Also, there is now more awareness of pertussis that has involved from a better diagnosis reporting.
How can families know if they’ve been vaccinated for pertussis or need boosters?
Families can check with their doctor, but we [as doctors] generally vaccinate during the routine immunizations that usually start at 2, 4, and 6 months of age. These are then followed by a booster around 15 to 18 months, and another booster at 4 to 6 years—that is for their early childhood vaccination. Another booster, for adolescents, is given at 11 to 12 years of age. This is new. People who were adolescents and who may not have got it should check with their physicians. As of 2005, schools in New York City require children in 6th through 10th grade to have a Tdap vaccination [combined tetanus, diphtheria, and pertussis vaccines].
Any adult that is going to be in close contact with an infant should get this booster because most [adults] probably having waning immunity or are not protected against pertussis anymore.
Are there risks to getting vaccinated?
Getting pertussis itself is much riskier than getting the vaccine. Most reactions to vaccines are local reactions and that would mean redness or soreness around the injection site or general soreness or tenderness. Some kids get a little fever and some could be fussy or be tired—these reactions usually resolve one to three days after the vaccination.
Vaccines are like any medicine. In rare cases you can have more severe reactions like a severe allergy, a high fever, and, sometimes, seizures—but again those are very, very unlikely.
What should parents do if they suspect their child has whooping cough?
Number one, they should contact the child’s care provider. Ideally, they should keep their child out of contact with someone who is not immunized, as well as children under 6 months of age and young children who have not been evaluated, until their child has been evaluated themselves.
How long does whooping cough last?
People are contagious very early during the start of the infection up until two weeks after the cough begins. The symptoms last a really long time. The first stage is one to two weeks where people have symptoms that look like a common cold. Then they have two to four weeks of severe coughing and another few weeks of a gradual resolution of the symptoms.
Dr. Melissa Stockwell is the medical director of the NewYork-Presbyterian Hospital/Columbia University Medical Center Immunization Registry (EzVac) and co-director of the Primary Care Clinician Research Fellowship in Community Health. She also serves as a pediatrician at a community clinic. Her research revolves around immunizations (and lack thereof), health technology, and health literacy.
