Pertussis (Whooping Cough)
I fear that if we keep listening to the anti-vaccine activists, pertussis will be just the first in a series of diseases that will return to plague us, causing needless suffering and anguish - Steven Salzberg
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image by: HealthWays/Regional Medical Center at Lubec
HWN Suggests
More Evidence Explains Why Whooping Cough Cases Are Increasing
Cases of pertussis, also called whooping cough, have been climbing over the past decade and a half. The disease, which causes severe coughing for months at a time and can cause death in infants, steadily declined over several decades after a vaccine became widely used in the 1940s. Cases reached their lowest rates in the 1970s and early 1980s, with just 1,000-3,000 cases a year.
Then cases started increasing again, slowly at first, in the late 80s and especially late 90s, though still remaining below 8,000 cases a year. Then the 2000s brought back numbers not seen since the 1960s: Every year since 2003 has had at least 10,000 cases, more recently hovering in the 20,000s. The 2012…
Resources
Postexposure Prophylaxis
Administration of postexposure prophylaxis to asymptomatic household contacts within 21 days of onset of cough in the index patient can prevent symptomatic infection. Coughing (symptomatic) household members of a pertussis patient should be treated as if they have pertussis.
Pertussis: A Reemerging Infection
Pertussis, also known as whooping cough, is an acute respiratory tract infection that presents as a chronic cough in most patients. Up to 17% of patients who develop a cough lasting more than two weeks have pertussis.
No big whoop: Adult pertussis may not produce the whooping cough
Whooping cough is the nickname for pertussis, a childhood disease that is now affecting teens and adults and becoming less true to its onomatopoeic moniker. People with pertussis make a whooping sound because they run out of breath after coughing hard several times in row; the whoop is the sound of a sudden, hard inhale.
Whooping Cough Without the Whoop - The Bad Lingering Cough
Although I have been practicing medicine since 2000, the first time I diagnosed whooping cough was in 2011 and ever since, I have been diagnosing more and more cases each year thereafter. However, what makes these cases a little unusual is that for ALL cases of whooping cough I have diagnosed, there was no characteristic whoop for which it is named after.
Whooping cough: Back, with a vengeance
Pertussis is an awful disease. A child in the throes of a paroxysm sounds like nothing else on earth. Children turn blue, give themselves black eyes, die. We kept it down to manageable levels with the help of a vaccine. That we would willingly bring it back it is beyond belief.
A Case of Pertussis: What Emergency Health Care Providers Need to Know.
The clinical presentation of pertussis may be variable depending on the age and immunization status of the patient. The classic presentation includes a triad of symptoms: paroxysms of coughing; an inspiratory whoop following cough; and posttussive vomiting.
Five Things to Know about Whooping Cough
Although pertussis usually starts with typical cold-like symptoms, it is often not diagnosed until after one to two weeks, when the illness progresses from a mild cough into the second stage of persistent and rapid coughing spells. This stage is known as the paroxysmal stage. The paroxysmal stage is categorized by violent coughing spasms that often result in vomiting and is followed by a whooping sound. These coughing episodes may occur a few times a day up to several times an hour and are often worse at night and can interfere with sleep. This stage can last up to three months.
I've Got Whooping Cough. Thanks a Lot, Jenny McCarthy
At this writing, I have been coughing for 72 days. Not on and off coughing, but continuously, every day and every night, for two and a half months. And not just coughing, but whooping: doubled over, body clenched, sucking violently for air, my face reddening and my eyes watering. Sometimes, I cough so hard, I vomit.
Measles and Whooping Cough Outbreaks: Here’s What Parents, Doctors, and Politicians Can Do
...pediatricians still have a lot of sway over the merely vaccine-hesitant. One way to persuade these parents to vaccinate, he says, is for pediatricians to get better training about how to deliver the vaccination message. That message should be “routine and strong,” Schaffner says, and doctors should be trained to answer common questions that might come up, rather than expressing exasperation at the first (or second or third) sign of reluctance.
More Evidence Shows Whooping Cough Evolving In Response To Its Vaccine
Pertussis vaccines seem to require booster shots sooner than they used to. Could evolution explain why?
Pertussis Vaccine In Pregnancy Protects 9 Of 10 Newborns From Whooping Cough
“The bottom line is that receiving Tdap during pregnancy is extremely effective in protecting infants against pertussis across the first year of life,” said senior author Nicola Klein, M.D., Ph.D., co-director of the Kaiser Permanente Vaccine Study Center and a clinical instructor at Stanford University School of Medicine.
We have a vaccine for whooping cough. So why's it an epidemic in California?
It's hard to blame any single cause for public health problems like the recent rise in whooping cough, but it's clear that anti-vaccine activists aren't helping.
Why Are Babies Dying of Old-Fashioned Whooping Cough?
The story of the whooping-cough outbreaks is more complex than just parents who don't vaccinate their kids.
Why Do We Need To Recontrol Whooping Cough?
Whooping cough used to be under control. The number of nationwide cases was dropping for years, and although the disease didn’t disappear, we were getting to the point where most people didn’t know anyone who’d had it. The question is, why did we lose control? Is a new strain of pertussis to blame? Or is it our own behavior?
Why Pertussis Is Making a Comeback
Whooping cough, a potentially life-threatening childhood illness, all but disappeared in the 1940s after a vaccine was developed. Why is it making a comeback now, when most children are vaccinated?
Why whooping cough is making a comeback
Whooping cough, a potentially life-threatening childhood illness, all but disappeared in the 1940s after a vaccine was developed. But in recent decades, the illness has been making a comeback. Changes in the vaccine and waning immunity are likely contributing to the resurgence of the illness, according to experts
Could this be whooping cough?
Whooping cough has not been eradicated despite widespread vaccination. The worldwide incidence of BPI is increasing, while vaccination programmes in the developed world seem to have reversed ...
I had whooping cough as a GP trainee – the experience informed my academic work and clinical practice
People can get whooping cough at any age, but children under the age of six months have a higher risk of complications (including death), which may be due to their immature immune systems and the fact that they haven’t finished the course of immunisation against the disease at this point.
Management of Whooping Cough (Pertussis)
Antibiotics reduce the period of communicability and should be initiated as soon as possible and within three weeks of the onset of the cough. Patients are no longer infectious after five days of appropriate antibiotic therapy. Antibiotics probably don't reduce cough duration in most patients.
My Wake-Up Call with Whooping Cough
One mother shares the story of her baby's terrifying experience of being diagnosed with pertussis.
Pertussis: The Identify, Isolate, Inform Tool Applied to a Re-emerging Respiratory Illness
Pertussis, commonly referred to as “whooping cough,” is a highly contagious acute respiratory infection that has exhibited cyclical outbreaks throughout the last century. Although vaccines have provided some immunity, many populations, including infants and pregnant women, remain at risk for serious illness.
Add Whooping Cough To The Growing List Of Vaccine-Preventable Epidemics
Unlike the measles vaccine, the DTaP and Tdap vaccines are closer to 80-90% effective, even after receiving all five doses.
Commentary
Pertussis remains a highly contagious disease with potential serious sequelae in very young children. Emergency physicians should remain vigilant for pertussis and other reemerging vaccine-preventable infections.
Pertussis in the Emergency Department
Pertussis, or whooping cough, was first described in the 16th century, and the causative agent was isolated in 1906. Nonetheless, pertussis remained a major cause of morbidity and mortality among children well into the 20th century.
Pertussis Post-Exposure Prophylaxis among Household Contacts: A Cost-Utility Analysis
Prolonged pertussis outbreaks have recently been reported across North America, prompting re-examination of control and prevention strategies.
The Unsung Heroes Who Ended a Deadly Plague
How a team of fearless American women overcame medical skepticism to stop whooping cough, a vicious infectious disease, and save countless lives.
To Prevent Deadly Whooping Cough Outbreaks, Give The Vaccine Ahead Of Schedule
There have been various reasons for the uptick in whooping cough outbreaks, and the anti-vaxx community is actually not (fully) to blame for this one. Many of the outbreaks can be explained by waning immunity in adults and older children, inadequate re-immunization (or booster shots) in teens and adults, and, to a much lesser extent, the anti-vaxx community advocating delaying vaccines in infants and young children.
More Evidence Explains Why Whooping Cough Cases Are Increasing
The verdict: waning immunity is the culprit, along with normal population growth and not having enough people immunized at the start. As adults who had immunity from childhood infections grew older, more of the population increasingly had been immunized with vaccines whose effectiveness waned over time.
About Whooping Cough
Who's afraid of the big bad cough? Whooping cough is a potentially serious disease that may start out like a regular cold. It can affect people of all ages and can be dangerous for you and your family. A whoop sound may occur between coughing fits as the patient tries to take in breaths
AdultVaccination.org
I thought whooping cough was wiped out in this country? Actually, high vaccination rates help keep diseases under control, but may not eliminate them. The immunity we get from whooping cough vaccines wears off over time, which is why we can get it again as adults. Whooping cough in adults may not be diagnosed because it may start very mild followed by a bad cough that people may think is just a “leftover” symptom from a cold. But adults can still pass the infection to others, even when it’s mild in them, so widespread vaccination is the best way to protect yourself and others.
Immunization Action Coalition
The Immunization Action Coalition (IAC) works to increase immunization rates and prevent disease by creating and distributing educational materials for health professionals and the public that enhance the delivery of safe and effective immunization services.
The History of Vaccines
Pertussis, also known as whooping cough, is an extremely contagious disease caused by the Bordetella pertussis bacterium. These bacteria produce toxins that paralyze parts of respiratory cells, leading to inflammation in the respiratory tract. The incubation period for pertussis is generally between 7-10 days long, but can last more than a month. After symptoms first appear, the disease can take anywhere from weeks to months to fully run its course.
VaccineInformation.org
All babies, children, and teens should get vaccinated against whooping cough as part of their regular checkups. Pregnant women need a dose in every pregnancy. Adults should also get vaccinated against whooping cough to protect themselves, their families and friends, and babies they may be in contact with. Babies and children need to be vaccinated with DTaP vaccine, and older children, teens, and adults should receive Tdap vaccine. These vaccines protect against diphtheria, tetanus, and pertussis (whooping cough).
Vaccines.gov
There are vaccines for children, pre-teens, teens, and adults. The childhood vaccine is called DTaP, and the pertussis booster vaccine for adolescents and adults is called Tdap. These are combination vaccines that protect against three diseases: diphtheria, tetanus and pertussis. Getting vaccinated against pertussis is especially important for families with and caregivers of new infants.
CDC
Pertussis, also known as whooping cough, is a highly contagious respiratory disease. It is caused by the bacterium Bordetella pertussis. Pertussis is known for uncontrollable, violent coughing which often makes it hard to breathe. After fits of many coughs, someone with pertussis often needs to take deep breathes which result in a "whooping" sound. Pertussis most commonly affects infants and young children and can be fatal, especially in babies less than 1 year of age. The best way to protect against pertussis is immunization.
Harvard Health
Infants under 6 months of age, adolescents and adults may have a cough that lasts many weeks without the characteristic whooping sound.
Infectious Disease Advisor
Pertussis is an acute respiratory tract infection caused by Bordetella pertussis and typified by a protracted paroxysmal cough illness. B. pertussis is the sole cause of epidemic pertussis and the usual cause of sporadic pertussis. Neither the disease nor immunization provides lifetime protection. Currently, worldwide prevalence is dampened only by continuous use of immunization.
KidsHealth
The first symptoms of whooping cough are similar to those of a common cold: •runny nose •sneezing •mild cough •low-grade fever After about 1 to 2 weeks, the dry, irritating cough evolves into coughing spells. During a coughing spell, which can last for more than a minute, the child may turn red or purple. At the end of a spell, the child may make a characteristic whooping sound when breathing in or may vomit. Between spells, the child usually feels well.
MedicineNet
Unfortunately, most people with whooping cough are diagnosed later with the condition in the second (paroxysmal) stage of the disease. Treatment with antibiotics is recommended for anyone who has had the disease for less than three to four weeks.
Todar's Online Textbook of Bacteriology
The disease pertussis has two stages. The first stage, colonization, is an upper respiratory disease with fever, malaise and coughing, which increases in intensity over about a 10-day period. During this stage the organism can be recovered in large numbers from pharyngeal cultures, and the severity and duration of the disease can be reduced by antimicrobial treatment.
WHO
Pertussis is a highly contagious bacterial disease of the respiratory tract, caused by Bordetella pertussis. It occurs mainly in infants and young children, and is easily transmitted from person to person, mainly through droplets. The first symptoms generally appear 7–10 days after infection, and include mild fever, runny nose, and cough, which in typical cases gradually develops into a paroxysmal cough followed by whooping (hence the common name of whooping cough). In the youngest infants, the paroxysms may be followed by periods of apnoea. Pneumonia is a relatively common complication; seizures and encephalopathy occur more rarely. Untreated patients may be contagious for three weeks or more following onset of the cough. Pertussis can be prevented by immunization.

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