Whooping cough causes, treatment

One of our concerns at the Department of Health is that we might see the number of cases of whooping cough climb even higher now that school has started. The likelihood of this scenario increases if adults and adolescents with whooping cough remain undiagnosed, because they are the largest reservoir of pertussis. Moreover, people can carry this germ without having symptoms of whooping cough and they can spread it. And as it spreads, the chances of infection increase for those people at the highest risk of hospitalization or death from whooping cough.

To reduce those risks, we ask that readers familiarize themselves with the risks and symptoms of whooping cough, and the preventive measures they can take to reduce those risks.

What is whooping cough?: Whooping cough is a highly contagious disease of the respiratory tract, caused by a bacterium that is found in the mouth, nose, and throat of the infected person.

Who gets whooping cough?: Many of the reported cases occur in young children, but the numbers are rising among adolescents and adults. We are seeing it here most typically in middle-school children.

What are the symptoms?: In infants and toddlers, the symptoms of whooping cough are reasonably clear. It starts out resembling a common cold, but within two weeks the cough becomes severe and is characterized by episodes of numerous rapid coughs followed by a crowing or high pitched whoop.

The symptoms in adults and adolescents can be more obscure. Often adults suffer from a persistent hacking cough that lingers. It may not make you feel sick enough to go to bed, and a number of the adults we've treated in Tompkins County have been going to work while sick. We advise adults and adolescents with a cough that lasts more than a week to seek medical attention and to ask your doctor about whooping cough. In most cases the problem may prove to be bronchitis, but a small number may be whooping cough, which should be treated without delay. We want people to get better, but our additional concern is to keep them from spreading the disease to others.

How does whooping cough spread?: Human beings are the only known reservoir of pertussis. Cough droplets carrying the germ are spread through the air, typically traveling a three-foot radius. People are most contagious in the very beginning of the illness when the membranes are producing a lot of phlegm, even before the cough sets in. This means it is difficult to treat people early in the disease process.

How serious is whooping cough?: Whooping cough can lead to very serious complications that include pneumonia, middle ear infection, loss of appetite, dehydration, seizures, encephalopathy (disorders of the brain), apneic episodes (brief cessation of breathing) and death. The whoop can cause a strain so severe it results in brain hemorrhage. People at highest risk are the very young and the elderly, though hospitalization and death are most common in the very young.

What about vaccination?: We vaccinate for whooping cough because it is preventable. Vaccination begins around the age of two months and is typically completed by age six because this group has the worst statistics for hospitalization and death from this disease. This also protects infants and toddlers from picking up the pertussis bacterium from adults who carry the germ but may be asymptomatic. Careful, extensive studies show no reason for concern with the safety of this vaccine. The only contraindication is if you've previously had either an anaphylactic (life-threatening allergic) reaction to the vaccine or encephalopathy.

How is whooping cough diagnosed and treated?: There are two ways to detect pertussis: A special culture and an antibody test. We've taken steps at the Tompkins County Health Department to make special test kits available throughout the county on an as-needed basis.

Whooping cough is treated with antibiotics and after five days of antibiotic therapy, the infected person is no longer contagious. Once a case is identified, we surround that case by prophylactically treating the people close to the patient. This helps to contain the spread.

Prevention is our goal. If you or someone in your family has a hacking cough that lingers for a week, see your doctor. And keep your children up to date on whooping cough and other childhood vaccinations.

Dr. Klepack is board certified in family practice. He is a member of the medical staff of Cayuga Medical Center and is medical director of the Tompkins County Health Department. He is in private practice at Dryden Family Medicine. Health Watch normally runs on alternating Thursdays.