Whooping cough

Understanding Whooping Cough: A Highly Contagious Disease

Whooping cough, or pertussis, is a highly contagious bacterial disease that can strike anyone but poses the greatest risk to infants and young children. Imagine a tiny baby, their little body wracked by uncontrollable coughing fits—this is what whooping cough looks like. It’s a condition that can turn a child’s life upside down, leaving them gasping for air with a high-pitched ‘whoop’ sound after each fit. This disease isn’t just a nuisance; it can be deadly.

The Symptoms and Spread of Whooping Cough

Initial symptoms are often mistaken for the common cold—runny nose, sneezing, mild cough—but these quickly escalate into something far more serious. The classic symptom is a paroxysmal cough, which means sudden bursts of intense coughing that can last several minutes. After each fit, the child may make a high-pitched ‘whoop’ sound as they try to catch their breath. This whooping noise is what gives pertussis its name.

But it’s not just infants and young children who are at risk; anyone can get whooping cough if exposed to an infected person. The bacteria, Bordetella pertussis, spread through airborne droplets from coughs and sneezes. It’s like a silent invader, lurking in the air until it finds its next victim.

Diagnosis and Prevention: A Lifesaving Approach

Diagnosing whooping cough can be tricky because symptoms vary widely between immunized and non-immunized individuals. A physician’s overall impression is often most effective, but lab tests like culturing, PCR, DFA, and serological methods can provide more definitive results.

Vaccination remains the primary method of prevention. The multicomponent acellular pertussis vaccine offers 71-85% effectiveness, but it’s important to note that immunity wanes over time—typically three to six years. This means older individuals can still spread the disease to those who are more vulnerable.

Antibiotics like erythromycin, clarithromycin, and azithromycin may be used for treatment, especially in high-risk groups or during outbreaks. However, these aren’t a cure-all; they’re most effective when given early to reduce infectiousness and prevent spread.

The Impact of Whooping Cough on Infants

Infants are particularly vulnerable to whooping cough. Nearly 50% of infected infants require hospitalization, and approximately 0.5% die from the disease worldwide. The risk is especially high for first-year infants, who can suffer complications like apneas (pauses in breathing), pneumonia, seizures, and encephalopathy.

These statistics paint a grim picture, but they also highlight the importance of vaccination. Before vaccines, the US reported 178,171 cases annually, with peaks every two to five years; 93% of these cases occurred in children under ten. The DTP combined vaccine led to a significant drop in pertussis incidence to around 1,000 by 1976.

Global Impact and the Future of Pertussis

Whooping cough is endemic worldwide, with 151,000 cases reported globally in 2018. It’s a leading cause of vaccine-preventable deaths, with an estimated 24 million cases per year and 160,000 deaths among young children in 2017. Epidemics occur cyclically every three to five years, and immunity declines over time.

Despite the availability of effective vaccines, reported whooping cough cases have reached their highest levels since 2014, with over 16,000 cases in 2024, a fourfold increase compared to last year. The CDC has confirmed two deaths related to the illness.

The journey from Louis W. Sauer’s development of the first vaccine in the 1920s to the acellular vaccines used today is a testament to medical progress. However, it also underscores the ongoing challenge of ensuring widespread vaccination and addressing the limitations of current immunity levels.

As we continue to navigate the complexities of whooping cough, one thing remains clear: vaccination is our best defense. By staying informed and ensuring that ourselves and our loved ones are vaccinated, we can protect against this highly contagious disease and its potentially devastating consequences.