Whooping cough infectious, even as an adult


Sept. 21--It started as a cough. A dry, irritating cough that later evolved into spells that lasted a full minute.

The episodes got so bad in less than a week that Dr. William John Cochran found himself lying on the floor. "I couldn't catch my breath," he said. "The cough was so severe that I'd pass out."

Cochran, 56, who suffers from asthma, thought that the repair work he was doing while renovating his son's home in Alabama was irritating his asthma. So, he just upped his intake of steroids until the coughing became so violent he ended up in the hospital.

When Cochran received the prognosis that he had whooping cough in April 2009, he was shocked. "Despite being a physician, I didn't realize that I needed to get a repeat vaccine for pertussis," he said. "I thought that the vaccination I had as a child was good for life."

Cochran, vice chairman of the Janet Weis Children's Hospital, Danville, is the example in Geisinger Health System's campaign to promote adult vaccinations. The state Department of Health has launched a new campaign to raise awareness of the need for adult vaccinations.

Whooping cough is an infection of the respiratory system caused by the bacterium Bordetella pertussis (or B. pertussis). It's characterized by severe coughing spells that end in a "whooping" sound when the person breathes in. Before a vaccine was available, pertussis killed 5,000 to 10,000 people in the United States each year. Now, the pertussis vaccine has reduced the annual number of deaths to fewer than 30.

The vaccine is part of the DTaP (diphtheria, tetanus, acellular pertussis) immunization. DTaP immunizations are routinely given in five doses before a child's sixth birthday. To give additional protection in case immunity fades, the AAP now recommends that children ages 11 to 18 get a booster shot of the new combination vaccine (called Tdap), ideally when they're 11 or 12 years old, instead of the Td booster routinely given at this age.

Kimberly Kilheeney, director of occupational health at Geisinger Health System, said immunity decreases seven years after someone had the disease. If a person had a vaccination as a child, by the time he reaches adulthood, he is way past needing a booster shot.

"Increase in adults getting whooping cough is directly related to waning immunity," she said.

According to a health advisory released in the summer by Everette James, Secretary of Health, there is also evidence of increasing numbers of cases in suburban Philadelphia and other parts of the Commonwealth.

No cases of whooping cough have been reported in Luzerne County, said Delphine Torbik, associate director of personal health, Wilkes-Barre Department of Health, Kirby Health Center. She said the center has received only two phone calls from adults inquiring about pertussis booster shots. "I hope more people become aware of the need for adults to be immunized," she said. "The most successful way of preventing the disease is by immunization."

Adults ages 18 and older who reside in Wilkes-Barre can get a booster shot free at the vaccination clinics Wednesdays from 1 to 4 p.m. and Thursdays from 9 to 11 a.m. Reservations are necessary by calling 208-4268.

All suspected or confirmed cases should be immediately reported to the Pennsylvania Department of Health at 1-877-PA-HEALTH or to the local health department where the patient resides.

Some 50,000 adults die annually nationwide from vaccine preventable-diseases, such as whooping cough, according to James.

Pertussis is known as the "100 day illness." It soon became 100 days of hell for Cochran.

The lack of sleep was exhausting for Cochran, who recalls being lucky enough to get about a half-hour of shut eye before more coughing spasms would set in and wake him up. Occasionally, he would find himself on the floor since the spasms were so violent that he was shaken out of bed. "The chest pain from coughing was so bad that I felt like someone took a sledgehammer to my chest," he said.

It wasn't until about three months later, that he was on the road to recovery.

Whooping cough is on the rise. By 2004, cases spiked past 25,000, the highest level it's been since the 1950s. It's mainly affected infants younger than 6 months old before they're adequately protected by immunizations, and children ages 11 to 18 whose immunity has faded.

Adults and adolescents with whooping cough may have milder or atypical symptoms than youngsters, such as a prolonged cough without the coughing spells or the whoop.

Pertussis is highly contagious. The bacteria spread from person to person through tiny drops of fluid from an infected person's nose or mouth. These may become airborne when the person sneezes, coughs, or laughs. Others then can become infected by inhaling the drops or getting the drops on their hands and then touching their mouths or noses.

When someone is diagnosed with whooping cough, the state DOH is notified. That is why the passengers on the flight during Cochran's trip to Alabama were contacted after his diagnosis.

Infected people are most contagious during the earliest stages of the illness up to about two weeks after the cough begins. Antibiotics shorten the period of contagiousness to five days following the start of antibiotic treatment.

Up to 80 percent of non-immunized family members will develop whooping cough if they live in the same house as someone who has the infection, Kilheeney said.

"Vaccines aren't just for kids anymore," Cochran said.

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