January 19, 2005

SIU Pediatrician Finds Whooping Cough Cases Increasing

Four decades after industrialized countries began reducing the prevalence of whooping cough by vaccinating children, the disease is now re-emerging in the United States.

Dr. Subhash C. Chaudhary, professor of pediatric infectious diseases at Southern Illinois School of Medicine in Springfield, says it’s important to remind parents of the necessity of vaccinations to help reduce the incidences of whooping cough.

"Every parent wants to keep their child from getting the disease, making sure they get vaccinations because that is the best way to protect them. If someone has whooping cough, they should seek treatment and stay away from very young infants who have not yet received their vaccinations," said Chaudhary.

In Illinois, whooping cough cases have increased more than ten times in the last ten years. Preliminary data shows more than 1,300 cases were reported in 2004, compared to 111 cases in 1994, according to the Illinois Department of Public Health. Chaudhary believes increased awareness about the disease, particularly in adolescents and adults, is one reason more cases are being reported.

"Whooping cough, also known as pertussis, is a very annoying bacterial respiratory disease characterized by persistent severe coughing spells and often accompanied by exhaustion and vomiting," said Chaudhary. "At the end of the series of forceful coughs, the patient is breathless and needs to take a deep breath. When air is inhaled through a narrow airway, a characteristic 'whoop' may occur, thus give it the name whooping cough."

Those most often diagnosed with whooping cough are young infants under the age of 2 months who are not yet vaccinated, as well as adolescents and young adults. More than 60 percent of the whooping cough cases reported in Illinois last year were experienced by those age 10 to 27 years.

Whooping cough usually isn't life threatening for older children and teens, who experience a milder form of the disease. Their only symptom may be a persistent cough. During the early phase, it can be easily passed to babies.

"In very young infants, the disease can be very serious. They may cough so long and hard that their face turns blue. They can stop breathing or develop pneumonia, seizures and bleeding in the brain. Many babies who get the disease are often hospitalized and they may die from it," said Chaudhary.

This bacterial infection is highly contagious and is easily spread through coughing and sneezing. An infected person is contagious from just before onset of symptoms until up to three weeks after symptoms start. Treating pertussis with antibiotics may or may not relieve symptoms, but the patient becomes noncontagious.

"Symptoms usually appear five to ten days after exposure to the bacteria. The first symptoms are similar to those of a common cold – a runny nose, sneezing, a low-grade fever and a mild cough. The cough gradually becomes severe, and after one to two weeks, the patient has spasmodic bursts of numerous, rapid coughs. During an attack, the patient may vomit and become exhausted," said Chaudhary.

Coughing attacks occur more frequently at night and increase in frequency for a couple of weeks. Coughing may last as long as ten weeks. Recovery is gradual and the coughing episodes from subsequent respiratory infections can recur for months after the onset of the disease.

Vaccinations for preventing whooping cough are given to children at ages 2, 4 and 6 months; 12 to 15 months; and 4 1/2 to 6 years. The vaccine is given in the same shot with diphtheria and tetanus vaccines (DTaP). Chaudhary says vaccines are effective, but some of them lose their immunity by the time a child reaches the teen years.

To help protect teens from getting the disease, a new booster vaccine is currently being developed. It is expected to be approved by the Food and Drug Administration by 2006.

Chaudhary joined the SlU faculty in 1977. He is board certified in pediatrics and pediatric infectious diseases. He may be contacted at SIU's Department of Pediatrics in Springfield, 217-545-0702.

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NOTE TO EDITORS:  A JPG image of Chaudhary is available by calling SIU Public Affairs at 217-545-2155 or e-mailing publicaffairs@siumed.edu.
CUT LINE:  Dr. Subhash C. Chaudhary, professor of pediatric infectious diseases at Southern Illinois School of Medicine in Springfield, checks patient X-rays in SIU's pediatrics clinic.