Whooping cough

First let me say that this is not an article to debate the vaccination issue but is rather an article to answer some questions that many parents have about Whooping Cough. With many children starting or going back to school, this August this is a great time to address this issue.

What is pertussis?
Pertussis is a bacterial respiratory illness that is spread through respiratory droplets typically during the first 2 weeks of illness. Pertussis can survive outside of the human body for up to 6 days.  During the first 2 weeks of illness, pertussis typically presents with similar symptoms as the common cold, however over time a severe cough can develop and last for weeks to months.  The cough has a distinctive whooping sound which gives it the nickname “whooping cough”. Pertussis has approximately a 7-10 day incubation period, meaning a person may not have symptoms until 10 days after exposure.

What is the chance that my child will get pertussis?
While the risk is very low, every year there are very small outbreaks here in Hawaii and across the United States.  According to the CDC statistics, Hawaii typically has far fewer cases than other states. Over the last 10 years the highest number of reported cases in a 1 year period in Hawaii was 147 cases back in 2005, most years we see 50-60 reported cases for the entire state.

Both, vaccinated and unvaccinated children may be at risk of contracting pertussis as the vaccine does not provide 100% coverage. There are more cases of pertussis in vaccinated children compared to unvaccinated children, however when you compare the % of infected children to healthy children within each of these populations, a greater % of unvaccinated children contract pertussis.

How serious is pertussis?
For the average healthy child or adult, pertussis usually results in a severe cough that lasts an average of 6 weeks with little or no complications, but may result in many sleepless nights for the entire family. The biggest con  cern is for infants; greater than 50% of infants under 1 year old who contract pertussis require hospitalization, usually because they need respiratory support. Infants under 3 months who are not breastfed and/or with older siblings in school are the greatest concern; the risk of exposure increases, their immune system and lungs are not strong, they do not have any antibodies from breast milk, and the first dose of the DTaP vaccine would provide very little coverage.

Testing for pertussis
Testing is typically only done in patients who are experiencing signs and symptoms of pertussis. Testing is done through a deep nasal swab during the first 3 weeks of illness.

Treatment of pertussis
For children and adults treatment is usually supportive. Antibiotics may be effective at treating pertussis if given in the first few weeks of illness but are sometimes given later to reduce transmission.  As stated above, infants may need hospitalization and respiratory support.

Image Credit: Emma Whitney Photography

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Dr. Marsha Lowery is a Naturopathic Physician with a practice in Grace Health Center in Makawao. Her practice focuses on Naturopathic primary-care with an emphasis in womenês health and pediatrics. She completed her ND degree at National College of Natural Medicine in Portland, OR. You call her at 808 633-8177 or go to www.MauiND.com

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