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Pertussis: no reason to whoop it up

My two-year-old daughter has a bad cough. I was told by a relative that she might have whooping cough, but I thought that was no longer a concern these days. Can my children still contract the disease?

Childhood immunizations have been largely responsible for eliminating many once-dangerous diseases. Pertussis, commonly referred to as whooping cough, is one condition that is easily prevented by following a regular pediatric immunization schedule.

According to Helen Hollingsworth, M.D., associate professor of medicine at Boston University School of Medicine and chief of the Section of Pulmonary, Critical Care, and Allergy in the Department of Medicine at Boston Medical Center, the name whooping cough comes from the unique sound associated with the disease. "Symptoms include a spasm of coughing --often four or five hard, repeated coughs," she says. "After the coughing, a whooping sound results when an infected child gasps for air, and the air rushes into a constricted esophagus."

Caused by a bacterium, Bordetella pertussis, whooping cough is an inflammation of the respiratory tract. It's highly contagious and commonly affects young children between one and ten years old. At first the symptoms are fairly mild, and can include a runny nose, low fever, and mild cough. The cough and nasal congestion continue to worsen, eventually becoming severe enough to cause the spasms that create the whooping sound. If untreated, the nasal and respiratory tract congestion can lead to pneumonia.

Whooping cough is rarely serious in children more than a year old. When it does appear, it often affects older children or teens who may not have been properly immunized. There are still several thousand cases reported annually throughout the United States. "The success of childhood immunization is largely responsible for the rarity of whooping cough," says Hollingsworth, "but there are still cases from time to time."

During the earlier stages, the disease can be treated with the antibiotic erythromycin, which sometimes can prevent it from progressing to a more severe stage. However, once the disease progresses to include severe coughing spasms, antibiotics are not effective. Hospitalization is sometimes recommended, and with proper care, regular hydration, and suction to keep blocked nasal passages clear, the coughing spasms eventually disappear.

Because whooping cough can be easily prevented with a series of regular immunizations, Hollingsworth urges parents to be certain that their children are immunized. The diphtheria-tetanus-pertussis vaccine (DTP) is administered five times over a period of four to six years. "The DTP vaccine is very effective," she says. "Whooping cough is rare for a reason, and regular vaccines can keep it that way."

The American Academy of Pediatrics recommends that DTP immunizations should occur at the following ages: 2, 4, 6, and 18 months old, with a booster shot some time between ages 4 and 6. For more information or for a schedule of all recommended childhood immunizations, visit the AAP's Web site, www.aap.org.

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on whooping cough or other health matters, call 617-638-6767.

2 February 2001
Boston University
Office of University Relations