A couple of different school districts in the St. Louis area have reported whooping cough outbreaks. We asked Dr. Timothy Casper, a pediatric emergency physician at Mercy Hospital South, what parents need to know to about whooping cough.
What is whooping cough?
Whooping cough (also known as pertussis) is a respiratory disease caused by a bacterial infection. It gets its name from a distinctive gasping sound that can follow the strong coughing fits the disease can produce. Pertussis symptoms can last for months. The disease is particularly dangerous for infants, who can suffer apnea and die (with or without a preceding coughing fit). For older, healthy children and adults, the infection is typically not quite so serious, but it is very unpleasant. There are anecdotes of patients breaking ribs from forceful coughing.
How can I tell if my child’s cough is caused by whooping cough and not a less serious ailment? Are there other symptoms?
Pertussis starts with the catarrhal (inflammation of the mucous membranes) phase, which lasts one to two weeks. These symptoms are runny nose, cough and a general feeling of discomfort, which are typical in kids and hard to differentiate from common viruses. High fever is usually not present. The main feature that distinguishes pertussis is the worsening and very prominent coughing fits, which typically start in the second week of illness. In contrast, most viral upper respiratory infections will be improving after a week. Post-tussive emesis (vomiting after a coughing fit) is another symptom that can indicate pertussis, though other conditions also can cause this to happen. The other main considerations are any known pertussis exposures and the patient's vaccination status.
Isn’t whooping cough covered by the typical childhood vaccines? Can my child become infected even after receiving the vaccine?
The primary immunization series does include pertussis - it's the "aP" in the DTaP and TDaP shots. However, even fully immunized people can sometimes still contract the disease - although they tend to have a less severe course. Immunity can also fade with time.
What causes a spike in whooping cough cases?
The disease can spread in close quarters, particularly when there is decreased herd immunity. The bacteria has no known reservoir outside of people, so in theory we could eradicate it like smallpox.
Is there anything else I can do to keep my child from contracting this illness?
Hand hygiene never hurts. Keep immunizations current for everyone in your household, including adults. Don't allow people who are unvaccinated or have infectious symptoms to hold your infant, and be aware of the vaccination requirements and exemptions of the daycares and schools you choose to send your kids to.