Question of the Week
October 25, 2004

Even those who may not have heard of pertussis, may be familiar with whooping cough (another name for the same disease). Regardless of which name you know, what does that name mean?

"Pertussis is a bacterial respiratory illness characterized by severe spasms of coughing that can last for several weeks or even for months. Pertussis is usually spread from person-to-person through close contact with respiratory droplets released when a person coughs or sneezes. Before the introduction of vaccination in the 1940s, pertussis was a major cause of serious illness and death among infants and young children in the United States. ... An increasing number of cases of pertussis have been reported to the CDC since the 1980s. The increases are greatest among adolescents (aged 10-19 years), but an increase is also seen among infants younger than 5 months old."

An increase in cases?

"Pertussis has increased dramatically in the past year, with several states reporting large outbreaks. Nearly 10,000 cases had been reported to the Centers for Disease Control and Prevention by the end of September, a significant increase over the nearly 6,000 reported by this time last year. Much of this increase is accounted for by outbreaks in Midwestern, New England and the Mid-Atlantic states. For example, Wisconsin had a total of 215 cases last year, but already has tallied more than 1,200 this year -- eight times what would normally be expected. ... North Dakota also has seen a spike, with more than 600 cases this year compared with only six in 2003, although that outbreak now appears to be dwindling...."

Even if you do not live in an area that has seen a recent increase in cases, pertussis is still something to pay attention to.

"The Society for Adolescent Medicine is urging parents to be aware that their teen's runny nose, watery eyes, and nagging cough may signal whooping cough, or pertussis. ... Late last year the U.S. Centers for Disease Control and Prevention issued a report stating that whooping cough is on the rise in the United States, primarily among infants too young to have received the full series of vaccinations against the disease. Whooping cough has also gained increasing attention lately due to news reports of outbreaks among adolescents in states such as New York, Illinois and Wisconsin. In March of this year, Reuters Health also reported on an outbreak of the condition in an Arizona middle school. Still, fewer than 20 percent of parents surveyed were concerned that their teenagers could contract the illness. 'Parents aren't nervous about it because they don't understand it,' Dr. Amy Middleman of Baylor College of Medicine in Houston, Texas told Reuters Health...."

Why is this an issue for teens?

"Recent evidence has shown that immunity begins to wane five to 10 years after the last round of vaccinations, which children receive at four to six years of age, making adolescents vulnerable to contracting the illness and spreading it to high-risk infants not yet fully immunized. In its earliest -- and most contagious -- stage, whooping cough is almost indistinguishable from the common cold, Middleman explained. After a week or two, its symptoms become more specific, as the affected person experiences violent coughing with intermittent periods of breathing difficulty. During this second stage, which can last as long as six weeks, people can cough so hard that they vomit, or even pull a muscle or break ribs. This is followed by the convalescent stage, which can last for months."

What symptoms mean pertussis?

"When symptoms are not classic, pertussis is difficult to diagnose and as a result, the disorder is likely to be underdiagnosed. Symptoms

  • runny nose
  • cough, severe, may be dry or may produce sputum
  • slight fever (102 F or lower)
  • severe coughing attacks
  • ends in a high-pitched, crowing sound when inhaling, or ends in a high-pitched 'whoop' (whooping cough)
  • coughing spell (paroxysm) may end in a momentary loss of consciousness
  • cough with difficulty breathing
  • vomiting during a severe bout of coughing
  • diarrhea
  • choking spells in infants

Unfortunately, these symptoms are not unique:

"Colds are caused by a virus and can occur year-round. The common cold generally involves a runny nose, nasal congestion, and sneezing. Other symptoms include sore throat, cough, and headache. A cold usually lasts about 7 days, with perhaps a few lingering symptoms such as a coughfor another week."


"Your head aches, and so does every bone in your body. You're cold one minute and hot the next. Your throat is scratchy, you're starting to cough - you may be getting the flu! ... Flu symptoms - headache, fever, chills, and dry cough - appear anywhere from 1 to 4 days after you've been exposed to the virus. Your temperature can get as high as 104 degrees Fahrenheit (40 degrees Celsius). You'll probably feel achy and exhausted and you may lose your appetite."


"Symptoms of a viral sore throat include a runny nose, cough, hoarseness, red or runny eyes, and diarrhea. If those sound like your symptoms, your sore throat is probably viral and will clear up on its own....

Questions of the Week:
What are the benefits of knowing what virus or bacterial infection is causing your symptoms? Why can it often be difficult for patients (and even doctors) to know the cause of an illness? How can knowing the cause change your interactions with others and/or your handling of the illness? Are there times when symptoms can be ignored as 'just a cold'? At what point do you change your behavior (where you go, the people with whom you interact)? At what point do you see a doctor?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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