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Whooping Cough: What you need to know.

Pertussis - Whooping Cough

Recent news reports have covered an outbreak of Whooping Cough. Detroit Medical Center’s Infectious Disease experts have prepared this webpage to help you understand what this condition is, how to recognize it, and how to prevent it.Whooping cough

What is Whooping Cough?
Whooping cough, also known as Pertussis, is a very contagious disease caused by a type of bacteria called Bordetella pertussis. These bacteria attach to the cilia (tiny, hair-like extensions) that line part of the upper respiratory system. The bacteria release toxins, which damage the cilia and cause inflammation of airways (swelling).

Why is it called “Whooping cough”?
Pertussis is also known as "whooping cough" because of the "whooping" sound that is made when gasping for air after a fit of coughing.

Pertussis in Michigan
In Michigan there has been a worrisome steady increase in pertussis over the past decade, peaking in 2010 with over 1,500 cases reported. In June 2012, Michigan Department of Community Health (MDCH) had received 847 reports of pertussis cases and is aware of one pertussis-related death. This represents a 21% increase over the 691 cases reported in 2011.


How could I become infected with pertussis ("catch this germ")?
People with pertussis usually spread the disease by coughing or sneezing while in close contact with others, who then breathe in the pertussis bacteria. Many infants who get pertussis are infected by older siblings, parents or caregivers who might not even know they have the disease. Symptoms of pertussis usually develop within seven to 10 days after being exposed, but sometimes not for as long as six weeks. Because pertussis in its early stages appears to be nothing more than the common cold, it is often not suspected or diagnosed until the more severe symptoms appear.

 

 

 

Some facts about Pertussis

  • Pertussis can cause serious illness in infants, children and adults and can even be life threatening, especially in infants.
  • Worldwide, there are an estimated 30-50 million cases of pertussis and about 300,000 deaths per year.
  • In 2012, 41,880 cases of pertussis (whooping cough) were reported in the U.S., but many more go undiagnosed and unreported. This is the most number of cases reported in the U.S. since 1955 when 62,786 cases were reported.
  • More than half of infants less than 1 year of age who get pertussis are hospitalized.
  • Vaccination of preteens, teens and adults – including pregnant women – with Tdap is especially important for families with new infants.
  • Pertussis is generally treated with antibiotics, which are used to control the symptoms and to prevent infected people from spreading the disease.

What are the symptoms of pertussis?
The disease usually starts with cold-like symptoms and maybe a mild cough or fever. After one to two weeks, severe coughing can begin. Unlike the common cold, pertussis can become a series of coughing fits that continues for weeks. Early symptoms (highly contagious phase) can last for 1 to 2 weeks and usually include:

  • Runny nose
  • Low-grade fever (generally minimal throughout the course of the disease)
  • Mild, occasional cough (cough may be minimal in infants, or not present at all)
  • Apnea — a pause in breathing (in infants)

As the disease progresses, the traditional symptoms of pertussis appear which may persist upto 10 weeks. Symptoms include:

  • Paroxysms (fits) of many, rapid coughs followed by a high-pitched "whoop"
  • Vomiting
  • Exhaustion after coughing fits.

Recovery Phase: The cough becomes less severe and less common. However, coughing fits can return with other respiratory infections for many months after pertussis started.

What is the treatment of Pertussis?
Pertussis is generally treated with antibiotics and early treatment is very important. Treatment may make your infection less severe if it is started early, before coughing fits begin. Treatment can also help prevent spreading the disease to close contacts (people who have spent a lot of time around the infected person) and is necessary for stopping the spread of pertussis.

Treatment after three weeks of illness is unlikely to help because the bacteria are gone from your body, even though you usually will still have symptoms. This is because the bacteria have already done damage to your body.

What are possible complications?
Pertussis can cause serious and sometimes life-threatening complications in infants and young children, especially those who are not fully vaccinated. In infants younger than one year of age who get pertussis, more than half (57%) are hospitalized. The younger the infant, the more likely treatment in a hospital will be needed. Of those infants who are hospitalized with pertussis, about:
- 23% get pneumonia (lung infection)
- 1.6% will have convulsions (violent, uncontrolled shaking)
- 67% will have apnea (slowed or stopped breathing)
- 0.4% will have encephalopathy (disease of the brain)
- 1.6% will die
Teens and adults can also get complications from pertussis. They are usually less serious in this older age group, especially those who have been vaccinated with a pertussis vaccine. Complications in teens and adults are often caused by the cough itself, and could be:
- Weight Loss (33%)
- Loss of bladder control (28%)
- Passing out (6%)
- Rib fractures from severe coughing (4%)

 

 

How can I prevent Pertussis?
The best way to prevent pertussis (whooping cough) among infants, children, teens, and adults is to get vaccinated. The most common pertussis vaccine is part of a multi-vaccine called Tdap. “tdap” stands for “Tetanus, Diphtheria and Pertussis.” READ MORE ABOUT THE TDAP VACCINE.

In those who have been vaccinated, in most cased the cough will not last as many days and coughing fits, whooping and vomiting after coughing occur less often. The percentage of children with apnea (long pause in breathing), cyanosis (blue/purplish skin coloration due to lack of oxygen) and vomiting is less.


Where can I get the vaccination?
The vaccination is available on a walk-in basis at each of the Occupational Health Services sites listed below:
 
DMC Occupational Health Services
University Health Center, 4K
4201 St. Antoine
Detroit, MI 48201
Monday - Friday 7 AM - 4 PM
(313) 745-4522

DMC Occupational Health Services
Sinai Grace Hospital , 2 West Main
6071 West Outer Drive
Detroit, MI 48235
Monday - Friday 7 AM - 3:30 PM
(313) 966-4807

DMC Occupational Health Services
Huron Valley Sinai Hospital, Lower level Garden
1601 E. Commerce Rd.
Commerce Township, MI 48382
Monday - Friday 7 AM - 3:30 PM
(248) 360-3495

Web resources:
State of Michigan Department of Community Health – Pertussis

Centers for Disease Control

 

 

 

 

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