By Dr. Bindu Nair and Dr. Liliana Palacio –
Whooping cough is an extremely contagious upper respiratory bacterial disease that causes violent coughing. The illness is caused by bacteria known as Bordetella Pertussis. The bacteria attached to the lining of the airways in the upper respiratory system releases toxins that lead to inflammation and swelling of the airway resulting in episodes of violent coughing, commonly known as Whooping Cough.
The disease is named for the characteristic sound produced when affected individuals attempt to inhale; the whoop originates from the inflammation and swelling of the laryngeal structures (voice box) that vibrate when there is a rapid inflow of air during inhalation. Dr. Liliana Palacio shared, “The infection is very contagious and is often spread to infants by family members or caregivers, who may be in the early stages of infection and not realize that they are suffering from whooping cough.” While people of all ages can come down with whooping cough, even if they’ve been vaccinated, it’s particularly dangerous for newborns’ because they do not have the immunity or the vaccine to fight off the infection.
The infection gradually resolves over a period of weeks, but the coughing can persist for several months. The most common complication and the cause of most whooping cough-related deaths is secondary bacterial pneumonia. Secondary bacterial pneumonia is bacterial pneumonia that follows another infection of the lung, viral or bacterial. Secondary pneumonia is caused by a different virus or bacterium than the original infection. Young infants are at highest risk for whooping cough and also secondary pneumonia. Other possible complications of whooping cough, particularly in infants less than 6 months of age, include seizures, encephalopathy (abnormal function of the brain due to decreased oxygen delivery to the brain caused by the episodes of coughing), reactive airway disease (asthma), dehydration, hearing loss, and malnutrition.
Whooping cough commonly affects infants and young children but can be prevented by immunization with the pertussis vaccine. Pertussis vaccine is most commonly given in combination with the vaccines for diphtheria and tetanus. (Pertussis is the “P” in the DTaP combination inoculation routinely given to children, and the “p” in the DTaP vaccine administered to adolescents and adults.) Dr. Bindu Nair advises, “Since immunity from the pertussis vaccine wears off with time, many teenagers and adults get whooping cough if they do not receive boosters. It is especially important for people who are routinely around infants to get the booster.”
For maximum protection against pertussis, children need five DTaP shots. The first three vaccinations are given at 2, 4, and 6 months of age. The fourth vaccination is given between 15 and 18 months of age, and a fifth is given when a child enters school, at 4-6 years of age. Preteens going to the doctor for their regular checkup at 11 or 12 years of age should get a dose of the DTaP booster, and adults who didn’t get DTaP as a preteen or teen should get one dose of DTap.
The easiest way for adults to ensure immunity is to get the DTaP vaccine instead of their next regular tetanus booster.
The vaccine has been deemed safe for pregnant women. To protect their infants, most pregnant women who were not previously vaccinated should get one dose of DTaP during the late second trimester or third trimester of pregnancy. During pregnancy, the antibodies she develops transfer to the infant, providing some additional protection to the infant before the baby can be fully vaccinated.
If not administered during pregnancy, it is recommended women be vaccinated prior to leaving the hospital or birthing center.
Whooping cough is thought to be on the rise for two main reasons. As Dr. Nair indicated, the whooping cough vaccine you receive as a child eventually wears off and also children are not completely immune to pertussis until they’ve received at least three vaccines, leaving those 6 months and younger at greatest risk of contracting the infection.
If you think you or your child is at risk contact your physician or pediatrician right away.
Dr. Bindu Nair
1720 Manatee Ave E
Bradenton, FL 34208
Dr. Liliana Palacio
5305 State Road 64 E
Bradenton, FL 34208
For more information about the effectiveness and safety of whooping cough vaccine, please visit www.cdc.gov.