Whooping Cough Returns
Also known as pertussis, whooping cough is an infectious disease, usually associated with children, caused by the bacterium, Bordetella pertussis. Its name comes from its symptoms: a dry, hacking, spasmodic cough that is followed by an intake of breath, which sounds like a whoop.
Once thought to have gone the way of polio and scarlet fever, pertussis among adolescents and adults has been on the rise since the 1980s. Reported cases from the Centers for Disease Control and Prevention during 1992-1994 show that among 13,615 cases, approximately 41 percent occurred in infants younger than 1 year; 20 percent occurred in children from 1 to 4 years of age; 11 percent occurred in the 5- to 9-year-old group and 28 percent occurred in those 10 years or older. Often it is misdiagnosed in the older population, because the characteristic whoop is not a symptom.
One reason whooping cough has made a comeback is that those not fully immunized as children cannot mount a response against the baccilli, says Donna Graffino, MD, assistant professor of pediatrics at UMDNJ-New Jersey Medical School (NJMS).
"The whole cell vaccine that was introduced in the '40s and used until the early '90s could produce side effects, such as high fever and seizures," she says. "If a child developed either of those after receiving the first in the series of three shots, he was not given the remaining two. A child with a history of seizures wouldn't be immunized at all." A new acellular vaccine that was recently produced, she says, has none of the adverse effects.
A second reason for the resurgence, says the pediatrician, is that the vaccine can, and sometimes does, lose its effectiveness. This is supported by the fact that three highly immunized populations in Massachusetts, Maryland and Missouri had outbreaks in the early and mid '90s. According to Graffino, the disease is treated with the antibiotic erythromycin.
For adults and older children, whooping cough is not a health threat. For children who are under 18 months old, however, it can be extremely serious. "In the very young, it can lead to pneumonia and hospitalization and in rare cases, even death," she says.
While it may not be life threatening to adolescents and adults, whooping cough can take its toll. A 12-year-old Montclair boy, Peter, came down with the disease in early November, last year. He was immunized as an infant.
At first, it seemed like any other cold, with sniffles and a mild cough. The boy's physician, who had been seeing a lot of viruses, diagnosed it as such, says Peter's mother. But the cough got worse. "Peter would cough so hard he would throw up," she says. "It's a nightmare watching a child with that spasmodic cough. He just couldn't get his breath." The symptoms got much worse at night. "Sometimes in the middle of the night, I would take him in the bathroom and turn on the hot shower to produce steam. That helped some," she says. A brew of peppermint tea helped a bit, too. "But nothing really controlled it," she says.
Initially, Peter stayed home from school. But after two weeks, he returned
to his usual activities, in spite of often spending a good portion of the
night coughing. He is nearly recovered, but has a lingering cough that gets
worse when he gets a cold. "Our physician said that may happen for
probably about a year," says his mother.
Spring - Summer 1998 Table of Contents