This is shaping up to be the worst year for whooping cough in Texas since the 1960s. State officials report nearly 1,700 cases of pertussis so far in 2013. About half of those are in North Texas.
So when is a cough ‘whooping cough’?
· Coughing spells that make the skin or lips turn red, purple or blue.
· Coughing followed by vomiting.
· Inability to catch a breath while coughing and the ‘whoop’ sound made by gasping for air.
· A lingering cough, six weeks or more. Adults often don’t know they have whooping cough because of lighter symptoms. (Source: kidshealth.org)
The sound of a whooping cough is painful to hear: an unrelenting cough punctuated by gasps for air. And it often starts out stealthy.
“It starts off as a cold,” says Dr. Laurie Gray at Cook Children’s Primary Care in Mansfield. “A runny nose, a little bit of a cough, nothing really major. Then, after a week or so, you start getting these coughing spasms.
“Kids under 1 may not cough, and that’s the danger. Kids under 1 have a tendency to stop breathing, and kids older than 1 having this coughing episode. It’s hard to watch.”
But sometimes parents can’t even make out that tell-tale whoop.
“We never heard that sound that everybody talks about,” says Shelley Newton, an Azle schoolteacher. Four summers ago, as the school year was ending, her 8-year-old daughter Alison got whooping cough, also known as pertussis. About two weeks later, she started coughing.
“My daughter would just cough and cough and cough until she threw up,” Newton remembers. “I never did throw up, but I did cough so hard that I basically separated my ribs. They just separated from the cartilage. It was very painful.”
Newton says she’d had whooping cough immunizations as a kid and her daughter was up to date on hers. But they both got sick in June and struggled with a cough through August.
“In China, they call it the 100-day cough,” says Dr. Christopher Perkins, Dallas County’s medical director. The vaccine offers the best defense against whooping cough, he says, but it loses strength over time.
“The vaccine will generally last about five years on average in a child,” he says. “The vaccine is not as potent as it used to be. So, it doesn’t confer as long a protection as the previous vaccine.”
Since 2005, the U.S. no longer uses a more potent version of the vaccine. The live whooping cough bacteria that had been used was considered more dangerous.
Dr. Perkins says it’s critical to keep vaccinations current: at 2 months, 4 months, six months and again at 12 to 15 months. Then, before starting school, at 4 to 6 years old. And a booster at age 11 or 12.
So, what’s behind the rapid rise in whooping cough cases? Russell Jones, Tarrant County’s chief epidemiologist, offers one explanation.
“What’s driving this outbreak appears to be the 7 to 11 year olds,” Jones says. “They’ve had their vaccine when they were 5. The immunity wanes and they are vulnerable until they can get their booster at 11.”
Jones says the county has sent advisories to local doctors to “think pertussis” and test for whooping cough so they can treat it as quickly as possible.
Dr. Laurie Gray says another factor could be the reluctance of some parents to immunize their children because of concerns about the possible side effects of vaccines.
“I know that when we are talking with parents who have vaccine concerns,” she says, “this is the one that we tend to emphasize most out of all of them – please if you only get one, please get this one. Because this is one that is real. It is here, and it will kill your baby potentially. There’s a good chance they’ll have bad complications if they get it.”
There have been two whooping cough deaths in Texas this year. Both were infants too young to be vaccinated.
“What we recommend doing is cocooning the baby,” Gray says. “That means the mom gets her pertussis vaccine when she’s pregnant, not afterwards. That means that every person in the family that is going to be near the baby is up to date on their whooping cough shots.”
Being up to date can prevent whooping cough, or at least lessen the symptoms. Mom Shelley Newton knows that.
“All I know is that if it was that bad and excruciating having had the vaccine, I can’t imagine what it would have been like without it,” she says.