WHOOPING COUGH

Whooping cough - or pertussis - is an infection of the respiratory system caused by the bacterium Bordetella pertussis (or B. pertussis). It's characterized by severe coughing spells that end in a "whooping" sound when the person breathes in. Before a vaccine was available, pertussis killed 5,000 to 10,000 people in the United States each year. Now, the pertussis vaccine has reduced the annual number of deaths to less than 30.

But in recent years, the number of cases has started to rise. By 2004, the number of whooping cough cases spiked past 25,000, the highest level it's been since the 1950s. It's mainly affected infants who are younger than 6 months old before they are adequately protected by their immunizations, and kids who are 11 to 18 years old whose immunity has faded.

Although whooping cough can occur at any age, it's most severe in unimmunized children and in infants under 1 year of age (early immunization can usually prevent this serious disease in babies). But more cases have been reported in teens and adults, because their immunity has faded since their original vaccination. That's why the American Academy of Pediatrics (AAP) recently recommended that kids who are 11-18 years old get a booster shot that includes a pertussis vaccine, preferably when they are 11 to 12 years old.

Signs and symptoms

Early signs and symptoms
Once you become infected with the bacterium that causes whooping cough, it takes about three to 12 days for signs and symptoms to appear. They're usually mild at first and resemble those of a common cold, such as:

• A runny nose
• Nasal congestion
• Sneezing
• Red, watery eyes
• A mild fever
• Dry cough
• General feeling of being unwell and loss of appetite

Later stage signs and symptoms
After a week or two, signs and symptoms become worse and usually include:

• Severe coughing attacks that bring up thick phlegm
• Coughing attacks — up to 15 coughs in a row — that end with a high-pitched "whoop" sound during the next breath of air
• In children, severe coughing that leads to vomiting or causes a red or blue face from the effort
• Fatigue from the exertion of coughing

Coughing characteristics
In adults, signs and symptoms of whooping cough may resemble those of bronchitis, a respiratory infection that causes a nagging cough. Babies and infants with whooping cough may not whoop at all, or at least not as loudly as older children do. Some children with whooping cough may experience choking spells and turn blue in the face as they struggle to breathe after extended coughing.

Severe coughing can result in tiny red spots caused by ruptures in blood vessels at the skin's surface (petechiae) in the upper body, as well as small areas of bleeding in the whites of the eyes. You may even bruise or break a rib if your coughing episodes are severe. Coughing may be worse at night.

What causes whooping cough?

Whooping cough is caused by infection with Bordetella pertussis or B. parapertussis bacteria. The infection easily spreads from person to person through respiratory secretions or mucus, which can be emitted during coughing or sneezing. The incubation period is about 7 to 14 days, meaning that symptoms develop about 1 to 2 weeks after exposure to the bacteria.

You can prevent or decrease the severity of whooping cough infection in your child by keeping immunizations up to date. Older children, teens, and adults can also get whooping cough and spread it to others. The whooping cough vaccine is also now available for adolescents and adults. Getting immunized helps prevent the spread of the disease. This helps protect babies, older adults, and others who are at high risk from getting complications from whooping cough. Adults can spread the illness, especially to unimmunized children. Babies who are not immunized may catch whooping cough from adult caregivers who may not even know that they have the illness.

You can get whooping cough more than once. After being immunized or after recovering from whooping cough infection, you are temporarily protected from getting a severe form of the disease again. But this protection does not last. You can get another whooping cough infection years later. You can reduce the risk of infection by getting a booster shot with the pertussis vaccine.