Chronic cough can be a symptom of many conditions, from allergies to lung cancer. Pertussis is often overlooked as the cause, according to a report in the Journal of the American Medical Association. News agencies reported increased rates of pertussis in early 2011 in most parts of the United States. Antibiotics such as erythromycin can shorten the course of the disease if they are started early enough, but are not very effective when the diagnosis is made late. Thus, public awareness of the disease is important.
Pertussis is also called whooping cough, because of the characteristic sound made by the restricted airways of children with the disease. However, the “whoop” is not so common in adult and adolescent cases. Reference 1 recommends that physicians use their overall clinical impression to decide whether lab tests are needed before treating patients for pertussis.
Vaccines have the potential to prevent pertussis. The Centers for Disease Control (CDC) recorded the highest number of reported cases in 1934, when 260,000 United States residents were infected. The number declined to 1,010 in 1976 as vaccination programs reached most families. Since that time, pertussis has been on the increase, with over 6,000 cases annually in recent years.
Recent studies, including one of a pertussis outbreak in a military boarding school in France, indicated that the effectiveness of the vaccine declines after about 10 years. Booster shots are generally administered in combination with tetanus and diptheria booster vaccines. The CDC currently recommends the Tdap (tetanus, diptheria, acellular pertussis) vaccine for individuals aged 10 to 64 years.
Complications of pertussis include pneumonia, seizure disorders, brain damage from lack of oxygen, and death. The Tdap vaccine has an excellent safety record and is effective in preventing these complications. Unfortunately, most Americans are not aware of the prevalence of pertussis and the possibility of getting vaccinated. Ask your doctor about getting your vaccinations up to date.
1. Cornia PB et al, “Does this coughing adolescent or adult patient have pertussis?” JAMA 2010 Aug 25; 304(8): 890-6.