Two-Week Cough? 20 Percent Chance it is Whooping Cough

Whooping cough is not epidemic in the United States, but reported cases appear to be on the rise since 1980.

"There is a 20% chance that if you have a cough for more than 2 weeks that it is Whooping Cough," said  Dr. Scott Landry at St. Peter's BJC hospital.

A vaccine for Pertussis or whooping cough as it is commonly known was developed in the 1940s. It is not 100 percent effective. But, it has decreased the incidence of the disease by 75 to 85 percent, so it is less prevalent in most towns.

Pertussis cases before 1940, numbered over 200,000 per year and they caused a large number of infant and elderly deaths.

Since the discovery of vaccines, the development of antibiotics, and the wide use of IV fluids for dehydrated patients, the death rate has dropped to less than 200 per year in the United States.

Instead of 200,000 cases a year, it is rare to have 10,000 cases reported. The number of cases being reported is on the rise because of better diagnostic tests and the ease of reporting using computers and the internet. These numbers are still low when compared to the years before the development of vaccines, antibiotics, and better IV fluid therapy.

But, according to the Centers for Disease Control (CDC) in Atlanta Georgia, many more cases of Pertussis are probably not reported because of the disappearance of symptoms once antibiotics such as erythromycin, minocycline, or Lincomycin are begun.

The symptoms of Whooping Cough normally develop a week after exposure to droplets in the air following an infected person coughing without covering their mouths. They spray droplets of mucus originating from the airways of their lungs which are filled with the bacteria Bordetella pertussis which causes the disease.

The symptoms of the disease are caused by the bacteria producing waste products that they secrete which irritates or destroys the fine hairs in our airways called cilia. The cilia may become swollen, produce more mucus, or may become paralyzed as the mucus sticks to the surfaces of our lungs and our breathing tubes. You cough to try to mobilize the mucus and to keep your airways open so you do not suffocate.  This coughing may become violent which gives this disease its common name, "whooping cough".

Pertussis is highly contagious and it can rapidly spread to all members of the family, school mates and people who normally associate with the infected person. People with cold like symptoms should isolate themselves for the first day or two or until they start antibiotics.

Pertussis symptoms may start out the same as a cold: slightly elevated temperature 100.4 F, runny nose, and coughing. Unlike a cold, Pertussis lasts up to 6 weeks and the cough can become violent and completely exhaust the infected person. In the worst cases it can cause seizures, vomiting, ear infection with damage to hearing, oxygen deprivation and brain damage if allowed to go untreated.

If a person vomits after coughing or appears slightly blue, they should be taken to a hospital emergency room for diagnosis and treatment.

Cough suppressants and expectorants typically do not help the symptoms and should be avoided.

In most cases, antibiotics are started well before any official diagnosis is made as the doctor will rely on the medical history and symptoms to reach a preliminary diagnosis before lab testing comes back.

If a person appears to be weak or dehydrated, they maybe admitted for IV fluids, antibiotics, and oxygen.

Whooping cough may be avoided if children get the recommended series of vaccinations which should be given at 2, 4, 6, 18 months and at age 5. They should receive a booster at age 12 and every 10 years throughout their lives.

There is an adult vaccine which has recently been recommended by the CDC for adults up to age 65 who have not received regular booster doses.

In addition, if a person has cold like symptoms, a noticeable cough, or vomits following a coughing spell, stay away from them and recommend that they go see a doctor immediately.

Antibiotics will kill the bacteria and help prevent spread of the disease so it is important that a person gets started on them right away.  Quick and accurate diagnosis cuts the duration of the disease and in the worst cases will save a life.

If you have any concern about the symptoms that have been described, call your doctor. He is eager to be of service to you and your family.