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Prevention Of Whooping Cough

Like the U.S. overall, Texas is seeing more cases of pertussis or whooping cough – nearly 1100 people have come down with it this year. Six have died. 

The reasons for the increase vary. Health officials say whooping cough is cyclical with outbreaks every 3-to-5 years. Researchers in a new study published last week concluded the vaccine for pertussis fades substantially over time. But Cheryl Millican of the Texas Department of Health Services says it’s best to stay on track with the recommended schedule for the vaccine.

Millican: Children need to be vaccinated at two months, four months, six months, and 15-18 months. Then they get a booster dose at four to six years of age, right before they start school. At 11-12 years, adolescents need a one-time booster for the T-dap vaccine, which is the new vaccine.

T-dap has Tetanus, Diphtheria, and Pertussis, so it has the extra component to protect adults from Pertussis. And any adult that has not had a T-dap needs one.

Baker: Pregnant women?

Infants cannot be vaccinated until they’re two months old. Five of the six deaths that have occurred in Texas have been in children that were too young to be vaccinated. They were less than two months old. And in the majority of the cases, the contact that infects the child is the mother. So pregnant women should get vaccinated after 20 weeks.  If they’re not vaccinated while they’re pregnant, they need to be vaccinated in the hospital before they leave.

Baker: What is whooping cough, just so we’re clear?

Millican: Whooping cough is a bacterial infection. It’s respiratory spread, so coughing, sneezing, and it’s a disease that affects the throat and the lungs, and it’s basically a cough that is just violent spasms that result in the inability to catch your breath, and as you cough and cough and cough, that inhalation of breath actually makes a “whoop” sound, and that’s why it’s called “whooping cough.”

Baker: But it’s not always there for infants or for adults, when this disease comes on.

The very young will often not have the “whooping” sound, and frequently neither do adolescents or adults. It seems to be that the whoop comes in the three to nine year-old range. That’s the most common area to time a frame to hear that sound.

Baker: Can anyone of any age get it?

Millican: Anyone of any age that’s not protected by the vaccine can get whopping cough. Infants are the most vulnerable because they don’t have the protection, they’re most likely to suffer from severe side effects such as brain damage, seizures, dehydration. Adults will have side effects such as broken ribs, blood vessels that’ll burst in the eye from the violence of the coughing. But most adolescents and adults will recover without a serious side effect.

Baker: What are the symptoms of this disease?

Millican: They start out mimicking a common cold. Runny nose, mild cough, low-grade fever; that’ll last anywhere from 7-14 days. And then it’ll gradually move on into the violent coughing episodes that reoccur multiple times a day. Coughing bouts seem to be more frequent at night and people have experienced up to 24-25 episodes at night. That portion of the disease can last anywhere from 1-6 weeks.

As you gradually get better, the coughing bouts resolve. They can be brought on again with maybe exertion, something like that, for almost two to three more weeks. So the actual span of disease can be almost 15 weeks. Infants are usually hospitalized; most adults may be hospitalized for a day or two, but the most common treatment is supportive and antibiotics.

Baker: So coughing, you said, can be just like a common cold. So at what point do you actually seek medical attention to determine if its something more than that?

Millican: If you have symptoms of the cold that doesn’t resolve within 7 to 10 days; the cough hangs on. Or, if you identify that “whoop,” I would then consult your physician.

Cheryl Millican is Immunization Program Manager for Texas Department of health Services, Region 23.

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