Once thought to be under control, Whooping Couch is on the rise. The Centers for Disease Control and Prevention (CDC) said Thursday that nearly 18,000 cases have been reported so far. That's twice the number reported at this point last year. At this pace, the number for the entire year will be the highest since 1959, when 40,000 illnesses were reported.
Nine children have died, and health officials called on adults - especially pregnant women and those who spend time around children - to get a booster shot as soon as possible.
"My biggest concern is for the babies. They're the ones who get hit the hardest," said Mary Selecky, chief of the health department in Washington, one of the states with the biggest outbreaks. Washington and Wisconsin have reported more than 3,000 cases each, and high numbers have been seen in a number of other states, including New York, Minnesota and Arizona. Texas is also reporting a higher number of cases than normal.
Health investigators are trying to figure out what's going on, and theories include better detection and reporting of cases, some sort of evolution in the bacteria that cause the illness, or shortcomings in the vaccine.
The vaccine that had been given to young children for decades was replaced in the late 1990s following concerns about rashes, fevers and other side effects. While the new version is considered safer, it is possible it isn't as effective long term, said Dr. Anne Schuchat, who oversees the CDC's immunization and respiratory disease programs.
Whooping cough, or pertussis, is a highly contagious disease that can strike people of any age but is most dangerous to children. Its name comes from the sound children make as they gasp for breath.
Experts believe whooping cough occurs in cycles and peaks every three to five years. But they have been startled to see peaks this high. Vaccinations are supposed to tamp down the amount of infection in the population and make the valleys in the cycles longer, said Pejman Rohani, a University of Michigan researcher who is co-leader of a federally funded study of whooping cough trends.
The government recommends that children get vaccinated in five doses, with the first shot at age 2 months and the final one between 4 and 6 years. A booster shot is recommended around 11 or 12.
Vaccination rates for young children are good - about 84 percent of 3-year-olds have gotten the recommended number of shots. But fewer than 70 percent of adolescents have gotten all their shots. Most states require pertussis vaccinations for school attendance.
In a possible indicator of a problem with the vaccine, investigators in Washington state were alarmed to see high rates of whooping cough in youngsters around 13 and 14.
Whooping cough is spread when an infected person sneezes or coughs. Tiny droplets containing the bacteria move through the air, and the disease is easily spread from person to person. The infection usually lasts 6 weeks.
Symptoms are very similar to the common cold:
- Runny nose
- Mild cough
- Low-grade fever
After about 1 to 2 weeks, the dry, irritating cough evolves into coughing spells. During a coughing spell, which can last for more than a minute, the child may turn red or purple. At the end of a spell, the child may make a characteristic whooping sound when breathing in or may vomit. Between spells, the child usually feels well.
If you suspect your child has whooping cough, it's very important that you take him or her to the doctor for testing.
Your child should be examined by a doctor if he or she has prolonged coughing spells, especially if these spells:
- Make your child's skin or lips turn red, purple, or blue
- Are followed by vomiting
- Are accompanied by a whooping sound when your child breathes in after coughing
- Is having difficulty breathing or seems to have brief periods of not breathing (apnea)
- Is lethargic
The doctor will take a medical history, do a thorough physical exam, and take nose and throat mucus samples that will be examined and cultured for B. pertussis bacteria. Blood tests and a chest X-ray also might be done.
Whooping cough is often passed to children from adults. Keep a careful eye on your child if they've been around other children or adults who exhibit prolonged coughing spells.
Children get vaccinated against whooping cough in five doses, with the first shot at age 2 months and the final one between 4 and 6 years. Then a booster is recommended around age 11. The vaccine's protection does wane and health officials have debated moving up the booster shot.
The CDC is urging adults and especially pregnant women to get vaccinated so they don't spread it to infants who are too young to get the vaccine.