A Letter Home on Whooping Cough

by Baylor Scott & White Staff on June 14, 2012

in Medical Information

Dear Parents/Guardians,

There has been a diagnosed case of active Pertussis or “Whooping Cough” at your child’s school.

Your child may have received a similar note from his or her school nurse this past spring advising that a schoolmate or classmate had a confirmed case of pertussis, or whooping cough.

young girl coughingIf you’re like most parents, you weren’t sure how to respond, whether to worry, or what to do.

Shaili Singh, MD, Pediatrician at Temple Towne Center, discusses whooping cough and details what you should do if your child has been exposed to the disease.

What Is Whooping Cough?

Whooping cough is caused by the bacteria bordatella pertussis. It causes uncontrollable coughing fits, and it’s highly contagious.

It can be very dangerous for unvaccinated infants and immunocompromised children and adults.

What Are the Symptoms of Whooping Cough?

“Pertussis starts with mild upper respiratory symptoms, such as a runny nose, and then it progresses to the coughing stage,” says Dr. Singh.

Other symptoms include:

  • Staccato cough — a series of repeated coughs
  • Inspiratory whoop — a deep breath marked by a high-pitched “whooping” sound
  • Vomiting
  • Low-grade fever
  • Fatigue

“The child will have a series of repeated staccato coughs — called paroxysms — usually in fits and spurts, and then take in a giant breath, called an inspiratory whoop — which is how pertussis gets its name,” Dr. Singh says.

Who Is Most at Risk?

“Anyone who is not vaccinated is most at risk. Infants less than two months have the highest risk — obviously, because they’re not vaccinated, and because they’re so small,” says Dr. Singh.

“Very often infants have to be put in the hospital,” notes Dr. Singh.

The vaccine for whooping cough is called the DTaP. It protects against three diseases — diphtheria, tetanus and pertussis. It’s generally administered in several doses throughout infancy and childhood.

According to the Centers for Disease Control (CDC), children who have not received any of the doses of the DTaP vaccine are at eight times the risk of having whooping cough than children who are immunized.

Others at risk for whooping cough:

  • Children and adults whose immunity has worn off
  • People with compromised immune systems, such as those receiving chemotherapy or having autoimmune disorders

How Can a Vaccinated Child Get Whooping Cough?

Recently in Central Texas, there have been around 90 confirmed cases of whooping cough, most of those in vaccinated children.

“We think it has to do with waning immunity. Most of the outbreaks that we’ve seen,” explains Dr. Singh, “have been in kids between the ages of 8 and 10. They get their immunizations when they’re younger — at 2, 4, and 6 months, and then at 4 years they get a booster. They’re not due for another booster until they’re 11.”

According to the CDC, immunity wanes around the ages of 8, 9 or 10, which makes them more susceptible to pertussis.

How Is Whooping Cough Spread?

Whooping cough is spread through respiratory secretions, Dr. Singh says.

  • Coughing
  • Sneezing
  • Sharing close contact with others

“A child is most contagious in the initial runny-nose phase and the first two weeks of the cough,” Dr. Singh says. “After that, the contagiousness of the cough decreases.”

 What Is the Treatment for Whooping Cough?

Treatment is simple. Because whooping cough is caused by bacteria, it generally responds well to antibiotic treatment, usually azithromycin, Dr. Singh says. Your child should begin to feel better within a few days.

“If your child has been sick and coughing a lot for more than a week — especially if you hear that whoop, get your child evaluated so he or she doesn’t risk spreading it to others.”

“Additionally, family members of children who are confirmed positive for whooping cough need to be treated as well — siblings, parents, grandparents — anybody living in the house,” says Dr. Singh.

If left untreated in otherwise healthy children or adults, symptoms can range from several weeks to months.

But it can be deadly for infants and for those with weakened immune systems.

What Are the Dangers of Whooping Cough?

Pertussis can be a very serious condition, especially in infants who are not fully vaccinated, says Dr. Singh.

In infants, whooping cough may cause:

  • Pneumonia
  • Convulsions
  • Bleeding behind the eyes
  • Apnea (stop breathing)
  • Encephalopathy
  • Brain damage
  • Death

If you suspect your baby may have been exposed to whooping cough, notify your child’s pediatrician immediately.

For children, teens and adults, according to the CDC, whooping cough may cause:

  • Weight loss
  • Incontinence
  • Rib fractures

What Do I Do If I Received a Letter from My Child’s School?

Local schools sent home two different notes, Dr. Singh says. Please carefully read the note sent to you.

Confirmed case of pertussis in your child’s school. In this case, there is a student at your child’s school who has a confirmed case of whooping cough. Dr. Singh says your child likely did not come in direct contact with the infected child. Over the next several weeks, you will need to watch for the symptoms of whooping cough in your child. If you notice symptoms of whooping cough, your child will need to be seen by his or her primary care provider.

Confirmed case of pertussis in your child’s classroom. In this case, there is a student in your child’s classroom who has as confirmed case of whooping cough, and your child was in close contact with him or her. Dr. Singh says your child will need to be examined and will likely be prescribed antibiotics.

How Is Whooping Cough Prevented?

“Get your vaccines!” Dr. Singh strongly advises.

According to the CDC, vaccines are the best way to protect against whooping cough. Additionally, studies show that people who are vaccinated are much less likely to be hospitalized or die from the disease.

Because newborns and infants are at greatest risk, “what we usually try to do is the cocooning effect. Have everybody around the newborn — siblings, grandparents, everybody — vaccinated. It doesn’t matter whether there’s been an exposure,” says Dr. Singh.

Some other tips to avoid spreading whooping cough:

  • Wash your hands regularly
  • Cough into your elbow rather than your hands
  • Avoid contact with anyone who is immunocompromised — for example, newborns and the elderly

Dr. Singh advises, “If your child has been sick and coughing a lot for more than a week — especially if you hear that whoop, get your child evaluated so he or she doesn’t risk spreading it to others.”

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