Is Whooping Cough Becoming More Common?

Whooping cough is a highly contagious upper respiratory infection caused by the bacteria Bordatella pertussis. It can be life-threatening in very young infants, adults over 65 and anyone with asthma, COPD or other lung diseases.

Recently, there’s been an uptick in the number of whooping cough cases doctors are seeing in their practices and in the emergency room. Amy Edwards, MD, a pediatric infectious disease specialist at University Hospitals, explains more about whooping cough and why it may be on the rise.

How Does Whooping Cough Spread?

“Like most respiratory illnesses, whooping cough (also known as pertussis) spreads through the air. When an infected person coughs or sneezes, droplets containing the bacteria are expelled from the mouth and may be inhaled by anyone nearby,” says Dr. Edwards. “However, it typically requires very close contact for this to occur. Brief, casual interaction with an infected individual is unlikely to spread the illness.”

What Happens When Bacteria Enters the Airway?

The windpipe and lungs are lined with tiny hairs called cilia, which help to “sweep” away mucus, germs and other foreign particles. When inhaled, the Bordatella pertussis bacteria attach to the cilia and release a toxin, damaging the hairs and causing the airways to swell. The swelling and inflammation gradually worsens and leads to the symptoms associated with whooping cough.

Three Stages of Infection

Whooping cough can be a persistent illness, taking weeks or months to fully resolve. It typically develops in three distinct stages:

• Catarrhal Stage. The first symptoms of whooping cough typically appear about one week after the bacteria enter through the airway. Early symptoms may include a runny or stuffy nose, mild cough and sore throat. Fever is rare and the symptoms may be similar to those of the common cold.
• Paroxysmal Stage. As the infection progresses, violent coughing becomes the primary symptom. The coughs come in clusters, or paroxysms, and are often followed by a high-pitched whooping noise when the patient attempts to draw breath after an episode of coughing. It’s common to have vomiting during or after these coughing fits.
• Convalescent Stage. During the final phase, the cough gradually improves. In some people, this stage can last for months.

How Is Whooping Cough Diagnosed and Treated?

If pertussis is suspected, a nasal swab will be taken and sent to the laboratory for testing. If the bacteria are present, antibiotics will be prescribed. “However, the majority of symptoms are caused by the damage done to the lungs by the toxins released by the bacteria,” says Dr. Edwards. “So, you can kill the bacteria with antibiotics, but the cough will continue until the lungs clear the toxin and heal. This can take weeks or months.”

“Hospitalization is sometimes required because the violent coughing can cause rib fractures and make breathing so difficult that patients can’t get enough oxygen. Up to one third of infants with pertussis will require some amount of hospital support.”

Why Is Whooping Cough on the Rise?

“As more parents refuse childhood vaccines, many preventable illnesses, including whooping cough, are becoming more common,” says Dr. Edwards. “Because the vaccine is not 100 percent protective, it requires a high rate of vaccination uptake in the community to prevent outbreaks.”

Whooping cough is part of the DTaP vaccine (diphtheria, tetanus, pertussis), which is typically given to children as a series of five shots. The first shot is given at two months of age and the last between four and six years of age.

Adults should receive booster vaccines every ten years. The vaccine for adults is called Tdap which contains the same amount of tetanus antigen as in the pediatric version, but less diphtheria and pertussis antigens. Pregnant women should receive the adult booster vaccine with each pregnancy to protect the baby for the first few months until they are old enough to be vaccinated.

Tips for Prevention

The most effective tool for the prevention of whooping cough is the vaccine. When combined with common sense practices like handwashing and covering your mouth when you cough, it’s possible to keep this potentially dangerous infection under control.

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The infectious disease experts at UH Rainbow Babies & Children’s provide advanced diagnostics and treatment for a full spectrum of childhood viral and bacterial illnesses. They can also advise parents about the benefits of vaccinating their children against transmittable diseases.