Pertussis
(Whooping Cough)
What is Pertussis?
Pertussis, also called "whooping cough", is a very contagious disease caused
by bacteria. Pertussis is usually mild in older children and adults, but
it often causes serious problems in very young children (infants less than one
year of age).
What are the symptoms of Pertussis?
Pertussis symptoms have two stages. The first stage (which lasts 1 to 2 weeks)
begins like a cold, with a runny nose, sneezing, mild fever, and a cough that
slowly gets worse. The second stage is marked by uncontrolled coughing spells
and a whooping noise (in young children) when the person inhales. During severe
coughing spells, a person may vomit or become blue in the face from lack of
air. Between coughing spells, the person often appears to be well. The
coughing spells may be so bad that it is hard for babies to eat, drink or
breathe. This coughing stage may last for 6 or more weeks. Adults, teens, and
vaccinated children often have milder symptoms that mimic bronchitis or asthma.
Some infants may only have apnea (failure to breathe) and may die from this.
How is Pertussis spread?
The bacteria that causes Pertussis lives in the nose, mouth and throat, and are
sprayed into the air when an infected person sneezes, coughs or talks. Other
people nearby can then inhale the bacteria. Touching a tissue or sharing a cup
used by someone with Pertussis can also spread the disease. The first symptoms
usually appear about 7 to 10 days after a person is exposed. Older children and
adults often spread Pertussis to infants without even knowing that they have the
disease.
Who gets Pertussis?
Pertussis is most common and most severe
among infants less than a year old, but anyone can get it. Pertussis can be
hard to diagnose in very young infants, teens and adults because they may not
have the severe cough, vomiting, or “whoop” symptoms. Symptoms often look like a
cold with a nagging cough.
Is Pertussis dangerous?
It can be, especially for infants. Pertussis can cause breathing problems such
as periods of no breathing (apnea), pneumonia, and can cause swelling of the
brain (encephalopathy), which can lead to seizures and brain damage. Pertussis
can also cause death, especially in very young infants.
How is Pertussis
diagnosed?
A doctor may diagnose a patient with Pertussis based on symptoms. A sample of
mucus may be taken from the back of the nose and sent to a Laboratory for
testing. The sample is then tested for the Pertussis bacteria. The Pertussis
microorganism is very difficult to grow in the lab, so the test may come back as
negative even if the patient has Pertussis. Treatment should be based on
symptoms, not the laboratory results alone.
How is Pertussis treated?
Antibiotics can make the disease milder if they are started early enough, and
will help to prevent transmission of the illness to others. It is strongly
recommended that anyone diagnosed with Pertussis stay home (away from others)
until 5 consecutive days of antibiotics have been taken. After 5 days of
treatment, the person with Pertussis is no longer considered contagious. Anyone
diagnosed with Pertussis and all that have had close contact with the
patient should complete the full antibiotic regimen, even if they were
vaccinated.
In additions, it is helpful
to get plenty of rest and fluids. Treatment for young children may include
supportive therapy such as fluids, oxygen, and mild sedation to help during the
prolonged period of coughing.
Can Pertussis be
prevented?
Yes,
there is a vaccine to help prevent Pertussis. It is given along with diphtheria
and tetanus vaccines in the same shot (DTaP). Five doses of vaccine, given in a
series starting at 2 months of age, are needed to protect a child from
Pertussis. When Pertussis is identified in a community, an “Accelerated
Schedule” of DTaP may be recommended. The accelerated schedule allows children
to receive the vaccine at an earlier age and in a shorter amount of time. By age
4 months, a child may have 70-90% protection against Pertussis with 3 doses of
DTaP. The vaccine works for most children, but it wears off after a number of
years. The vaccine is not given to persons 7 years of age or older.
Until recently there was not a
pertussis containing vaccine for anyone over 7 years of age. In the last few
months two new vaccines have been approved for the vaccination of adolescents
and adults. Boostrix, which is the brand name of a Tetanus, diphtheria, and
Acellular Pertussis vaccine, is licensed for adolescents 10 years through 18
years of age. Adacel, which is also a Tetanus, diphtheria, and Acellular
Pertussis vaccine is licensed for 11 years through 64 years of age.
The Mohave County Department of
Public Health Nursing Division currently has a limited supply of these
vaccines. Our main focus is to vaccinate the parents and direct caregivers of
infants less that one year of age. Also, some people who have been directly
affected by the current pertussis outbreak may qualify. It must have been a
minimum of five years since the last dose of tetanus/diphtheria containing
vaccine was received in order to qualify. If you are interested please contact
your local health department nursing division to see if you qualify. You can
also ask your primary care physician if they carry these vaccines.
Is the Pertussis vaccine
safe?
Yes, it is safe for most people. Some
children will get a slight fever and be cranky for a day or two after receiving
the DTaP vaccine. Some children will have a sore spot and some swelling or
redness where the shot was given. Only rarely will a child have a more serious
side effect, such as prolonged crying, convulsions or high fever. DTaP
(diphtheria, tetanus, and acellular Pertussis vaccine) is less likely to cause
side effects than the DTP (diphtheria, tetanus and whole-cell Pertussis vaccine)
and is now used routinely in the United States. However, following the 4th
and 5th DTaP doses there are more local reactions (pain, redness, or
swelling at the site of injection) compared with the first 3 DTaP doses.
Though there is a very slight
risk of problems caused by the vaccine, Pertussis or whooping cough is extremely
serious. It can last for weeks or months and lead to serious complications
among many people. Pertussis causes about 10-20 deaths each year in the United
States. That is why experts recommend that all infants and children be given a
full series of DTaP vaccine unless there is a medical reason not to receive the
vaccine.
If you think you may have
been exposed to someone with pertussis or are having symptoms of pertussis
