One of the success stories of widespread immunization conducted earlier in the century was the vaccination of pertussis, also known as whooping cough. This disease often led to a devastating lung infection, causing many deaths in children. It was pretty well suppressed for many years due to immunization, but recently, more and more cases are being reported, especially in areas where un-immunized people have been prevalent. 5000 new cases are reported in the U.S. each year, and it appears the number keeps growing. Because of this, many physicians have to be made especially aware of the diagnosis of disease, so we can once again prevent a potential epidemic.

Whooping cough is a contagious infection that is so named due to the sound a person makes with this irritating, repeating cough. The bacterium that is usually responsible is Bordetella Pertussis. Children younger than 1 year of age and the elderly are the most susceptible, but even healthy adults (especially un-immunized adults) can contract the disease leading to a chronic cough. Contaminated respiratory droplets from people who have contracted the disease spread the disease.

Symptoms Follow A Classic Three Stages Of Disease Lasting About Six To Eight Weeks:

Catarrhal Stage: This first stage is defined by a hacking cough usually at night. Symptoms are similar to a cold with a runny nose, congestion and sneezing. This is usually the most contagious period and lasts about a couple of weeks.

Paroxysmal Stage: After a couple of weeks, the coughing can get worse, irritating and repetitive. Sometimes the cough is so bad that the person can vomit from it. Other complications from repeated coughing can be eye hemorrhages, hernias and coughing spells. The typical whooping cough is present during this period, although young infant may not develop the characteristic sound. Antibiotics tend to be much less effective during this stage.

Convalescent Stage: This is the third and final stage, where the coughing finally subsides. However, another upper respiratory infection may trigger the symptoms.

Treatment:

Drug: Antibiotic treatment is also used for treatment of pertussis with Erythromycin being the main drug of choice at any clinical stage. Erythromycin shortens the course of illness if administered early. After the onset of the paroxysmal stage of pertussis, antibiotics do not alter the clinical course, but they can clear the organism from the nasopharynx and thus limit the spread of disease. Other drugs include Trimethoprim-sulfamethoxazole (Bactrim, Septra), azithromycin (Zithromax) and clarithromycin (Biaxin).

Vaccination: The Diphtheria-Tetanus-Pertussis Vaccine (DTP) has been very effective in preventing this disease from occurring. The vaccine is given about five times until four to six years of age, and it is important for parents to keep up with their child's immunizations. Side effects of the DTP vaccine have included fevers and soreness at the site of injection, and a safer alternative may be the acellular pertussis vaccine (DtaP), which is reported to have less problems. This can be given starting at 2,4,6,15 months and at 4-6 years of age.

If a doctor suspects someone having pertussis, he or she will often order lab tests including a chest X-ray, blood work and a bacterial culture, which is obtained in the nasal passages. Once diagnosed, if the disease is thought to be mild in nature, the physician will place the patient on antibiotics. It is also recommended that the child gets rest and a cool mist humidifier should be used to help with the breathing. As a child often vomits due to the violent coughing, it is important they get adequate fluids to prevent dehydration. If the doctor believes the patient to be hospitalized, antibiotics will be given intravenously and possibly oxygen support.

The most important thing we can do as parents to combat this disease is prevention. Keeping close attention of children's vaccination schedules are paramount. The key times to remember are 2 months, 4 months, 6 months, 15 months, and 4 to 6 years.