Kids Love Dr. Barton

Boosters Rid Kids of Whooping Cough

by Dr. Douglas Barton, M.D., Pediatrician 01/29/2009

We’ve heard a great deal about the “whooping cough” lately. The St. Charles (MO) County Health Department and Francis Howell School District have both released statements indicating “epidemic” concerns.

But what really is whooping cough and are your kids safe from it?

Whooping cough is the name given to the illness caused by Bordatella Pertussis, a respiratory bacteria. This bacteria, unlike a cold, gets down into the lungs and causes its mischief there. In most children over the age of four or five, it causes a prolonged cold. Initial symptoms are those of a basic cold with runny nose and cough and sometimes a low grade fever. Children may or may not feel a little run down. At this point, whooping cough is indistinguishable from the common cold.  The only difference is that if a child receives the correct antibiotic at this point in illness, the illness may not last as long.

As the illness progresses, children may develop the classic hard, non-stop cough that leaves them gasping for air at the end of a coughing fit, the classic “whoop.”  Most teens won’t develop the “whoop,” but many younger children will. Another indication of the severity of the cough is throwing up because the cough is so hard.  At that point, antibiotics don’t help the child, but they do prevent further spread of the infection to others. The illness typically runs its course over four to six weeks.

Infants and toddlers who catch pertussis are much more likely to become quite ill.  They may require supportive oxygen. Some will end up in the intensive care unit.  Infants also have a tendency to just stop breathing due to the infection. These are the patients at the highest risk.

There is an immunization for pertussis. It is part of the DTaP that all infants and kindergarteners receive. It is only about 85 percent effective, but each booster doses increases its effectiveness. This immunity tends to wear off over time, however, so many five year olds are not immune until they get their five-year-old booster shots.

Teenagers are not immnune. But the thinking that they are immune has led to them being carriers of the illness and also prompted notices from health departments and school districts. The newest national vaccine guidelines now recommend that children 11 years old and up receive a pertussis vaccine as part of their tetanus booster. This booster used to be given at 15 years old and did not contain the pertussis component. While this booster is also not perfect, good immunization levels in the community will help prevent the spread of this illness to those most susceptible to severe illness. Check with your physician.



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