Incidence of Whooping Cough on the Rise: Know the Symptoms

Little Girl CoughingThe number of whooping cough cases in New Jersey this summer more than tripled since this time last year, according to the Centers for Disease Control and Prevention, with cases in New York, Pennsylvania and Connecticut also nearing epidemic levels. How can you protect your family?

Whooping cough, clinically known as pertussis, mainly affects infants younger than 6 months old, who are not yet adequately protected by immunizations, and kids 11 to 18 years old, whose immunity has started to fade.

Symptoms of Whooping Cough
Because pertussis usually begins with cold-like symptoms, it is often not suspected or diagnosed until more severe symptoms appear. Severe coughing may begin after one to two weeks. Early symptoms can last for 1 to 2 weeks and usually include:

  • Runny nose
  • Low-grade fever (generally minimal throughout the course of the disease)
  • Mild, occasional cough
  • Pauses in breathing

As the disease progresses, the typical symptoms of pertussis appear and include:

  • Fits of repeated, rapid coughs followed by a high-pitched “whoop”
  • Vomiting
  • Exhaustion after coughing fits

While not everyone with pertussis coughs or “whoops,” the characteristic sound, as this link demonstrates, is unmistakable.

Patients with pertussis, although often exhausted after a coughing fit, usually appear fairly well in between. Coughing fits generally become more common and severe as the illness continues, and can occur more often at night. The illness may be less severe for those who have been vaccinated with a pertussis vaccine.

When to Call the Doctor
Call our offices if you suspect that your child has pertussis or has been exposed to someone with pertussis, even if your child has already received all scheduled pertussis immunizations.

Your child should be examined by a doctor if he or she has prolonged coughing spells, especially if these spells:

  • Make your child’s skin or lips turn red, purple or blue
  • Are followed by vomiting
  • Are accompanied by a whooping sound when your child breathes in after coughing
  • Cause difficulty breathing or are accompanied by brief periods of not breathing (apnea)
  • Make your child lethargic

To make a diagnosis, the doctor will take a medical history, do a thorough physical exam, and take nose and throat mucus samples that will be examined and cultured for B. pertussis bacteria. Blood tests and a chest X-ray also might be done.

A confirmed case of pertussis will be treated with antibiotics, usually for 2 weeks. Many experts believe that the medication is most effective in shortening the duration of the infection when given in the first stage of the illness, before coughing spells begin. But even if antibiotics are started later, they’re still important because they can decrease the risk of spreading the infection. Ask your doctor whether preventive antibiotics or vaccine boosters for other family members are needed.

Some kids with pertussis need to be treated in a hospital. Infants and younger children are more likely to be hospitalized because they’re at greater risk for complications such as pneumonia, which occurs in about 1 in 5 children under the age of 1 year who have pertussis. Up to 75% of infants younger than 6 months old with pertussis will require hospital treatment, as for these infants, pertussis can be life-threatening.

If your child has been diagnosed with pertussis and is being treated at home, seek immediate medical care if he or she has difficulty breathing or shows signs of dehydration.

Can It Be Prevented?
Whooping cough can be prevented with the pertussis vaccine, which is part of the DTaP (diphtheria, tetanus, acellular pertussis) immunization. DTaP immunizations are routinely given in five doses before a child’s sixth birthday. To give additional protection in case immunity fades, the American Academy of Pediatrics (AAP) now recommends that kids ages 11 to 18 get a booster shot of the new combination vaccine (called Tdap), ideally when they’re 11 or 12 years old, instead of the Td booster routinely given at this age. eMedical Urgent Care offers the Tdap vaccine.

The CDC also recommends that adults over 19 years of age receive a dose of Tdap as well, and that anyone (including those over 65) who may come in close contact with a child under 12 months of age receive Tdap to help protect the child from the disease.

Sources:

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