Whooping cough on the rise, but can be prevented

April 04, 2013 By Susan D’Agostino, advanced practice registered nurse

This past year, whooping cough made headlines across the United States as large outbreaks were reported in the regions of Washington and Wisconsin. Currently, Minnesota is experiencing a whooping cough (pertussis) epidemic. In November 2012, 35,000 cases were reported nationwide.

Even with the attention whooping cough is getting in the news, many still don't know what it is and how to prevent it. Whooping cough (pertussis) is a highly contagious, airborne disease caused by the bacteria Bordetella pertussis. It spreads when an infected person coughs or sneezes while in close contact with others, who then breathe in the bacteria. Pertussis infection can cause serious illness in some people and can be fatal to infants and the elderly. The good news is that it's a vaccine-preventable disease. The DTaP and Tdap are combination vaccines that help prevent pertussis as well as diphtheria and tetanus. The DTaP and Tdap vaccine effectiveness rates are very high.

A respiratory illness, whooping cough often starts like the common cold, with runny nose or stuffiness, sneezing, mild coughing and sometimes mild fever. In most cases, severe coughing begins after one or two weeks, and fits of this violent, rapid coughing can persist for weeks. Whooping cough got its name because the coughing fits can be so violent that all air is forced from the lungs, causing the person to then to take a big breath that makes a “whooping” sound. An important note: Infants don't always show signs of coughing; instead they may display life-threatening pauses in breathing (apnea).

Many infected with pertussis don't know they can spread the disease, since the first few weeks are easily mistaken for the common cold. That's why it's important to take these preventive steps:

• Whenever possible avoid contact with people displaying cold symptoms, especially parents of infants and young children.
• Administer the DTaP vaccine to infants and children. The vaccine is administered at 2, 4, and 6 months of age, followed by a fourth shot at 15 to18 months, and the final shot between ages 4 and 6.
• Teens and adults should receive one dose of Tdap then Td (tetanus and diphtheria booster) every 10 years.
• Pregnant women should request a Tdap vaccine later in their pregnancy. Maternal pertussis antibodies transfer to the newborn and can help protect the baby before the first vaccination at 2 months. Women should receive a Tdap booster postpartum (before hospital discharge) if the vaccine was not administered during pregnancy.
• Caretakers of children should receive a Tdap booster two weeks before contact with an infant.

If you're not sure whether you need the Tdap vaccine, or can't remember the last time you had a booster, talk to you healthcare provider.

Susan D'Agostino, MSN, APRN, FNP, is an advanced practice registered nurse with the Hartford HealthCare Medical Group primary care practice in New Britain. For information on physicians, please contact our free Need-A-Physician referral service by phone 1.800.321.6244.