Whooping Cough on the Rise in Wisconsin

Whooping Cough is on the rise in Wisconsin. And health experts say now is the time to crack down on the disease, before any infected children take it along back for the start of school.

About 700 cases of Whooping Cough, or Pertussis, were reported in Wisconsin in 2003. So far this year, more then 1300 people have gotten it. Officials say the growing number reflects the state's vigilance in reporting Whooping Cough.

Whooping Cough is a contagious bacterial disease that can infect the respiratory tract of all ages, though it's most serious in infants and children.

It's spread by the droplets from an infected person coughing and usually occurs after repeated indoor face to face contact.

It starts out like a cold, and then progresses to spells of explosive coughing that can interrupt breathing, eating, and sleeping. The cough is commonly followed by vomiting and exhaustion. After the cough, the patients may make a loud "whooping" sound as they struggle to breath. That's where the disease gets its nickname. Although rare in older kids, adolescents and adults symptoms can be milder and without the typical "whoop."

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Whooping Cough

What is it?

  • Pertussis, commonly known as "whooping cough," is an infection of the respiratory tract caused by Bordetella pertussis bacteria.

  • A pertussis infection is very contagious and can be quite serious. People become infected with Bordetella pertussis bacteria by inhaling contaminated droplets from an infected person's cough or sneeze.

  • Once inside the airways, pertussis bacteria produce chemical substances (toxins) that interfere with the respiratory tract's normal ability to eliminate germs.

  • Pertussis bacteria also produce chemicals that cause inflammation, damaging the lining of the breathing passages.

  • Although most infants in the United States are now immunized against pertussis, this immunity usually fades as a person enters early adulthood.

  • About 90 percent of nonimmune family members are likely to develop pertussis if they live in the same household as someone who has the illness.

  • Currently, 25 percent of pertussis cases in the United States occur among adolescents and adults (often in nursing homes and on college campuses).

  • In fact, adults and teenagers (who are not usually diagnosed as having pertussis) are now a major source for spreading pertussis to infants and children.

  • Once an unimmunized child has been infected after exposure to a person with pertussis, it usually takes three days to 21 days for symptoms to begin.

Symptoms

  • The first symptoms of pertussis may be similar to those of a common cold, including nasal congestion, runny nose, sneezing, red and watery eyes, mild fever, and a dry cough.

  • After about one week to two weeks, the dry cough becomes a wet cough that brings up thick, stringy mucus. At the same time, coughing begins to occur in long spells that may last for over a minute, sometimes causing a child to turn red from effort or blue from lack of oxygen.

  • At the end of a coughing spell, the child gasps for air with a characteristic "whooping" sound. Infants may not whoop at all or as loudly as older children.

  • Severe coughing spells can lead to vomiting and may make it hard for a child to eat or drink. Severe coughing can also cause petechiae (tiny, red spots caused by ruptures in blood vessels at the skin's surface) in the skin of the upper body, as well as small areas of bleeding in the whites of the eyes.

  • Because adults and adolescents with pertussis may have milder symptoms, they may be thought to simply have "bronchitis."

Treatment

  • Your doctor can confirm pertussis by taking cultures of respiratory fluids for examination in the laboratory. This involves taking a sample of secretions from the nose or throat and identifying the pertussis bacteria in the secretions. Blood tests and a chest X-ray may also be done.

  • Pertussis is treated with antibiotics, usually erythromycin. Some experts believe that treatment is most effective when antibiotics are started early in the course of the illness. Follow your doctor's schedule for giving antibiotic medication.

  • Antibiotics are also very important in stopping the spread of pertussis bacteria from the infected child to other people. Ask your doctor's advice about the need for giving prophylactic (preventive) antibiotics or vaccine boosters to others in your household.

  • Encourage your child to drink water, fruit juice, and clear soups to prevent dehydration.

  • In some cases, a child with pertussis may need treatment in a hospital. Almost all infants with pertussis who are less than six months old receive hospital treatment for their illness, and about 40 percent of older babies with pertussis are also hospitalized.

How long does it last?

  • Pertussis lasts for several weeks or longer. There are usually two weeks of common cold symptoms, followed by two weeks of severe coughing, followed by two weeks of a convalescent period when coughing occurs less often.

  • In some children, the convalescent stage may last for months.

Prevention

  • Pertussis can be prevented by the pertussis vaccine, which is part of the DTaP (diphtheria, tetanus, acellular pertussis) or DTP immunizations.

  • These important immunizations are routinely given in five doses before a child's sixth birthday.

  • The pertussis vaccine has dramatically decreased the number of cases of whooping cough that occur each year and saved countless lives.

Source: www.nlm.nih.gov (National Library of Medicine Web site) contributed to this report.