Whooping cough is the common name for pertussis, a vaccine preventable infection that has unfortunately not gone away, even as many children get multiple doses of a vaccine to protect them from pertussis as a part of the childhood immunization schedule.
Why is whooping cough still such a big problem, while many other vaccine preventable infections, like polio, measles, and diphtheria, etc., become less common in the United States?
In addition to lower vaccination rates in some groups of kids because of parental worry over vaccine safety and the use of alternative immunization schedules, the protection from the pertussis vaccine decreases over time. That makes many teens and adults susceptible to pertussis unless they have received a newer version of the tetanus booster that includes the pertussis vaccine (Tdap - Tetanus, Diphtheria, and acellular Pertussis).
Unvaccinated teens and adults who get pertussis can then infect children and newborns and infants who have not completed the three dose primary series of the DTaP (Diphtheria, Tetanus, and acellular Pertussis) vaccine, leaving them less fully protected against pertussis.
Since pertussis and pertussis outbreaks are not uncommon, it is important to recognize pertussis symptoms in case your child gets sick.
Pertussis symptoms usually start just like regular cold symptoms about 6 to 21 days after being exposed to someone else with pertussis, often an adult with a chronic cough. These initial pertussis symptoms typically last a week or two and might include a low-grade fever, runny nose, congestion, sneezing, and a cough.
Next, just as you would be expecting a child's cold symptoms to be improving, the child with pertussis actually starts to get worse, and develops symptoms which can last an additional 3 to 6 weeks, including:
- coughing spells or fits, which might end in the classic 'whoop' sound
- vomiting after coughing spells (post-tussive emesis)
- cyanosis or blue spells after coughing
- apnea or episodes where an infant actually stops breathing during or after a coughing spell
These pertussis symptoms then gradually improve over the next few months.
Children with pertussis often do not have other signs and symptoms, such as:
If your child is coughing and also has these symptoms, then he may have RSV or another infection, and may not have pertussis, especially if he has been fully vaccinated and has not been exposed to anyone with pertussis.
What You Need To Know About Pertussis Symptoms
Parents should see their pediatrician if they think that their child might be developing pertussis symptoms or seek more immediate medical attention if your younger child has severe symptoms, such as apnea or prolonged coughing fits.
Other things to keep in mind about pertussis and pertussis symptoms include that:
- The diagnosis of pertussis is sometimes overlooked, as a child's cough is blamed on more common infections, such as RSV or pneumonia. Be sure to tell your pediatrician if you think that your child has been exposed to someone with pertussis, anyone with a chronic cough, or if you simply think that your child might have pertussis.
- A bacterial culture or polymerase chain reaction (PCR) test can help to diagnose pertussis, although many children are first diagnosed just based on the symptoms they have.
- Early treatment with antibiotics can help make make your child less contagious to others but has not been shown to make much of a difference in amount or duration of symptoms.
- Adults with pertussis often just have a chronic cough for several months and don't have many of the other symptoms associated with pertussis in kids
- The Advisory Committee on Immunization Practices (ACIP) recommends that adults between the ages of 19 and 64 get one dose of the Tdap vaccine if they have never had it before.
- Adults who will have contact with infants less than 12 months old, including parents, grandparents (even if they are over 65 years old), child-care providers, and health care workers, should get a Tdap vaccine if they have not had one yet, even if it has been less than 10 years since their last tetanus booster.
CDC. Preventing Tetanus, Diphtheria, and Pertussis Among Adults: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine. MMWR. December 15, 2006 / 55(RR17): 1-33.
Gregory DS. Pertussis: A disease affecting all ages. Am Fam Physician - 1-AUG-2006; 74(3): 420-6
Kliegman: Nelson Textbook of Pediatrics, 18th ed.
Long: Principles and Practice of Pediatric Infectious Diseases, 3rd ed.
CDC. Recommended Adult Immunization Schedule --- United States, 2011. MMWR. February 4, 2011 / 60(04);1-4.