15 Oct Pertussis: A Multigenerational Cough
By: Ruben J. Rucoba, MD
“She couldn’t stop coughing, and she made a weird sound when she was breathing,” Lisa (not her real name) said. She brought her 6-week daughter, Julianna (also not her real name) into the office, and was anxious and frightened. “It was like she had trouble catching her breath.”
Julianna was sleeping in her stroller, quiet as a mouse at the moment. On my laptop, I Googled for an audio file of pertussis. “Did it sound like this?” I asked as I played the clip.
“Yes, that’s EXACTLY what she sounded like!” Lisa said.
As I suspected, Julianna had pertussis, more commonly known as whooping cough, an infectious disease caused by a bacteria called Bordetella pertussis. Pertussis has three stages:
- The early (or catarrhal) stage looks like a common cold with a runny nose, mild cough, and low-grade fever.
- The paroxysmal stage: the child has fits or paroxysms of coughing, often with a distinct “whoop” after the cough. One example of the whoop can be heard here: Click here. But be aware that sometimes children do NOT have a whooping sound, especially smaller infants. In this stage, children may also vomit after coughing, have difficulty breathing, and sometimes turn blue. In infants, pertussis can be quite serious, and even lead to death.
- The convalescent stage can last for weeks, especially in older children, pre-teens, and adults. During this stage, the cough is not as severe, but persistent. In adults, a case of pertussis is often called “the 100-day cough” because symptoms can last for weeks or months.
Babies get vaccinated against pertussis, as part of their DTaP shots (the P is for pertussis), but these don’t start until 2 months, so newborns younger than that are particularly vulnerable. Immunity against pertussis wanes, so children entering 6th grade (11 years old) are required to get a booster. Immunity continues to wane so that adults are often not susceptible. The cough is not fatal at this age, but these are the people who transmit the germ to newborns, so it is very important to immunize everyone who is around newborns: mothers, fathers, daycare workers, grandparents, aunts, uncles, etc.
This is why when you deliver a baby, your gynecologist recommends you get a pertussis booster if you haven’t had one recently. So make sure everyone who regularly comes in contact with your baby has had a recent pertussis booster.