Whooping Cough Outbreak May Be Worst Such Epidemic in 50 Years

An epidemic of pertussis, or “whooping cough,” has descended on California. As of last week, seven deaths have been blamed on the disease and 2,174 cases have been reported.

Graphic courtesy of the Los Angeles Times

On Monday, the California Department of Public Health said that compared to last year at this time, there are six times the number of reported cases, and we could be on the edge of the worst epidemic in 50 years.

What’s more, there’s legitimate concern that this will soon spread to other states around the country.

For many years, the last pertussis vaccine was given when children started school (approximately age 6). In more recent years, the Center for Disease Control and Prevention has recommended a booster vaccine (called Tdap) to prevent the illness for all adolescents and adults.

So what are the symptoms of whooping cough?

Stage 1

The first stage, also known as the catarrhal stage, lasts 1-2 weeks. It resembles a simple upper respiratory infection. Cough, runny nose, sneezing, body aches, and low grade fever are the most common. Many believe they simply have a cold.

Stage 2

After 2 weeks, the cough becomes more severe. This is the beginning of stage 2; it can last as long as 6-10 weeks. Coughs will come in paroxysms, or bursts of rapid, harsh coughs, as the infected person is trying to expel thick mucus. The coughing will increase in severity over two weeks and then very slowly diminish. At the end of the cough, as the person inhales, you will hear the characteristic whooping sound. The cough can be so severe that one can lose their “breath” and even turn a little blue (cyanosis), from a lack of oxygen. Frequently, the cough is so harsh that the person will vomit at the end of the coughing spell. These coughing attacks occur more frequently at night; some will have as many as 24 attacks of coughing in 24 hours.

Stage 3

When the coughing begins to diminish in severity and frequency, it is considered the third stage. But remember, this stage can last many weeks.

How is pertussis transmitted?

Whooping cough is highly contagious and is spread among people by direct contact with fluids from the nose or mouth of infected people. People contaminate their hands with respiratory secretions from an infected person and then touch their own mouth or nose. In addition, small bacteria-containing droplets of mucous from the nose or lungs enter the air during coughing or sneezing. People can become infected by breathing in these drops. Adults can get the disease, and generally, they get a milder case than children. 

How can you tell you have pertussis?

Your doctor can make the diagnosis. Your history and physical examination will provide information that will lead your physician to make the diagnosis. A special test for the bacterium, Bordatella Pertussis, can be sent to your local lab to get confirmation.

How do you treat pertussis?

Since whooping cough is caused by a bacterium, it is treated with antibiotics. There is no clear evidence that treating with antibiotics after the first couple weeks will be of any benefit to the patient. There is no proven treatment for the severe coughs, though many will try various cough preparations.

So, if you are experiencing these symptoms and you have not been vaccinated, see your physician.

What is best way to avoid getting pertussis?

  • Get vaccinated! Ask your doctor about the Tdap vaccine for adults and children.
  • Wash your hands frequently.
  • Avoid contact with people who are coughing.
  • Disinfect common areas such as work stations and door knobs.

The physicians at U.S. HealthWorks Medical Group are available to help with vaccination, evaluation and treatment.

 – Dr. Alesia Wagner, Regional Medical Director, U.S. HealthWorks Medical Group of California


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