Answer
Whooping cough is caused by an acute bacterial infection of the respiratory tract. The name Pertussis was coined in 1670 and means "violet cough." Pertussis was common in early 1900s, but after routine immunization began in the 1950s the incidence greatly decreased.Recently there has been a resurgence in Pertussis, the number of cases in the US has risen from arou nd 1000 per year in 1976 to over 25000 per year in 2004. Over one-third of the cases are in adolescents and adults. Infants have the most severe disease. We have seen many cases of infants presenting with apnea (stopping breathing) that required admission to the Children's Hospital. We have often seen older children and adolescents presently with a chronic cough caused by Pertussis.
Clinical symptoms
Symptoms start as a flu-like illness with cough, fatigue and fever. There is usually a worsening of the severity and frequency of the cough. The cough often has repetitive cycles with a whoop at the end of the cough cycle. Over several weeks the cough gradually decreases in severity. Infants under four months of age are the most severely affected. They can develop pneumonia or apnea (episodes of stopping breathing)
Diagnosis
Diagnosis is based on clinical symptoms and a throat swab.
Treatment
Antibiotics can decrease the amount of bacteria in the airway and make the infected individual less contagious, but generally it does not change the course of the illness. Immunization starting at two months is the most important method to protect against infection. The American Academy of Pediatrics has recently recommended a booster vaccination for adolescents 11 to 12 years old as waning immunity is thought to be a cause of the increase in Pertussis infections in older children and adults.
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