Learn about Whooping Cough

Male Speaker: Doctor Marcus, there is a term we use in medicine called the 100 day cough, whooping cough. Is that on the rise, decline; we vaccinate kids for it so can we -- even concern about it now? Doctor Michael Marcus: Whooping cough or Pertussis was a serious respiratory tracked infection 50 years ago. We started vaccinating children for whooping cough pertussis many years ago and for a while we saw a very nice decrease in the episode of whooping cough in children. And in fact, in very young children, it's uncommon to see whooping cough. However, what we have seen is two things; first, there are occasional children who do not get protected by the vaccine that we commonly administer and that's true for all vaccines, no vaccine is perfect. These children can get whooping cough; we also know that there are several other types of viruses and even bacteria that can give you a disease that looks like whooping cough even though it's not pertussis. These bacteria and viruses, we do not have immunizations for. And thereby, we can have a disease that's called whooping cough, even though it's been caused by a different organism. We also know that vaccines don't last forever. Generally speaking, the effect of the vaccine wears off over 5-10 year period. After the patient has been vaccinated as a child, by the time they are an adolescent or young adult, that vaccine benefit is worn off. And so some patients are still at risks for developing whooping cough at that point. Instead of the standard whoop that we used to think about, what they have is just prolong periods of this nagging harsh cough lasting up to 3 months. Without a question, whooping cough is a potentially life threatening illness, especially in the very young. Whooping cough leads to severe inflammation of the airways; can lead to blockage of airflow to the lungs, can rob the brain of oxygen, and can if not properly cared for lead to death. Therefore, it is still very important that children be vaccinated for pertussis during their childhood and infancy to prevent this serious infection for making a big come back. Male Speaker: There had been some parents who have refused vaccines and their kids actually got whooping cough, did that happen? Doctor Michael Marcus: Oh! Absolutely, there have been a number of cases in the literature where refusal of vaccination by individual parents and even by certain communities have lead to epidemics of this infection to come back. We know that bacteria causing whooping cough is out there, we have not eliminated it from the world and it will come back very rapidly if we let our guard down and stop vaccinating our children. Male Speaker: In fact in England, there was a period where they stopped to vaccinate kids and the epidemic just came back, and you say, oh, go, go back and do it again. Doctor Michael Marcus: We have seen this over and over again whenever that situation occurs, the minute you stop vaccinating, this infection returns with serious consequences. Male Speaker: There is a new vaccine targeted for kids over 11, then now, we now can give the pertussis vaccine to older kids, is that true? Doctor Michael Marcus: There it is, and it is a vaccine which has eliminated many of the concerns and side effects that previous vaccines. And it allows you to boost those children after that 10 year window has come, whereby, the original vaccinations series affect has worn off. Male Speaker: Young mothers who get pregnant, who have no protection against whooping cough -- get whooping during pregnancy, is that a problem? Doctor Michael Marcus: It certainly can be a problem; it could lead to a decrease in oxygen levels in the blood and lead to problems with the developing fetus. Male Speaker: So sometimes, people are being treated for asthma or some viral pneumonia and in actuality, a prolong cough could be whooping cough. Doctor Michael Marcus: It certainly can be. And I think that message here is that if you have a symptom that persists and it's not responding to the first line of treatment being given, re-evaluate the patient and make sure you are treating the proper disease. Male Speaker: A simple blood test checking for an antibody or pertussis doesn't mean you have the disease, is that true? Doctor Michael Marcus: That is very true. There are certain tests that can help diagnose this disease and other tests that do not. Any patient who's been given a vaccination at any time in their life will have some antibody in their bloodstream for pertussis. That means the patient has had a normal vaccine response. The only way to document pertussis is to actually try to culture the organism or look for evidence of it in the nose or in the secretions. Male Speaker: What test can they do in the secretions that's very reliable to that? Doctor Michael Marcus: Well, they do special genetic DNA tests to take a look for the genes of the bacteria in the secretions. In this way, we can see the bacteria has been there and we know has caused the infection. You can also do cultures which can let the bacteria grow. If this is a tricky bacteria to grow, you aren't always successful in isolating it on these samples. Male Speaker: If someone did get a pertussis like disease, how would you approach to the treatment say when you have doubt? Doctor Michael Marcus: The treatment would require combination approach. Antibiotics are always administered. The antibiotics are more important to prevent the spread of this infection to other people. The problem is once the serious cough develops, the antibiotics are very limited in their ability to relieve this symptom. There are other types of medications which can help relieve the spasm and inflammation which causes the cough and these medications have to be individualized for every single patient. Male Speaker: Thank you Doctor Marcus.