Whooping Cough Threatening Our Community  

As published in The Hill Country News

In recent years there has been a dramatic resurgence of pertussis here in our area and across the US.  In just the first 3 months of this year, Williamson County has had 11 confirmed cases and 29 probable cases of pertussis.  This increase is believed to be caused by adult's protection from childhood pertussis immunization wearing off, along with failure to immunize all children.  Pertussis or "Whooping Cough" is an upper respiratory disease caused by the bacteria Bordetella pertussis.  Its clinical features can be very similar to other upper respiratory illnesses therefore it can be very challenging to diagnose.

Illness is classically divided into 3 phases.  The catarrhal phase is the earliest phase and lasts 7-10 days.  Its clinical features include a runny nose, red eyes, malaise, low-grade fever, sneezing, and a mild cough.  This gradually gives way to the paroxysmal phase.  The paroxysmal phase can last 1-6 weeks and is characterized by paroxysms or bursts of numerous rapid coughs.  Following the coughing, there is a long inspiratory gasp accompanied by a high-pitched whoop (where the disease gets its name).  The last phase is the convalescent phase where the nuisance cough gradually resolves over 1-2 weeks.  This classic picture is usually more evident in children.  Many adults will seemingly just suffer a very bothersome and prolonged cough that generally responds poorly to the variety of cough treatments available over the counter or by prescription.   Additionally, the disease is more dangerous in children, particularly infants.   More than half of infants less than one year old who get the disease must be hospitalized.  Complications that can occur with pertussis include vomiting (due to gagging), pneumonia, seizures, encephalopathy, and even death.  As one might suspect, people usually spread the disease by coughing or sneezing while in close contact with others, who then breathe in the bacteria.

The diagnosis of Pertussis can be made clinically by your physician if there is a high suspicion for the disease.  Otherwise, the diagnosis is made by a culture of the bacteria from a swab of the patient's nose.  If the diagnosis of pertussis is made or suspected, it is important for specific antibiotics to be started.  The antibiotics may help to shorten the course of the disease, but are most important in helping to stop the spread of the disease.   Pertussis is a highly contagious disease so containing the spread is important for the community.  Therefore, if you are in close contact with a person that has been diagnosed with pertussis, or if your symptoms fit those described above it is important to see your doctor.   Early evaluation and potential treatment is critical in minimizing your chance of infection and spread of the disease. 

The best way to prevent pertussis is to get vaccinated.  With the introduction of a vaccine in the 1940's, the number of pertussis cases reported nationally fell from approximately 200,000 a year in the prevaccine era to a low of 1,010 cases in 1976.  In the U.S., the recommended pertussis vaccine for children is called DTaP. This is a safe and effective combination vaccine that protects children against three diseases: pertussis, diphtheria, and tetanus.  Vaccine protection for tetanus, diphtheria, and pertussis can fade with time.  Before 2005, the only booster available contained tetanus and diphtheria (called Td), and was recommended for adolescents and adults every 10 years. Today there are boosters for adolescents and adults that contain tetanus, diphtheria, and pertussis (Tdap). Pre-teens going to the doctor for their regular check-up at age 11 or 12 years should get a dose of Tdap.  Adults who didn't get Tdap as a pre-teen or teen should get one dose of Tdap instead of the Td booster.  Vaccination will protect yourself, your children, and your community.

Further information regarding pertussis:

1.  Pertussis FAQs

2.  Williamson County Health Department