DEAR DR. GOTT: I had a bad case of whooping cough as a child. I am now 68 years old. Is it possible to get whooping cough more than once? I have been reading of quite a few cases of it here in Montana and that has me wondering. Also, if my husband has never had whooping cough, should he have the preventive shots for it?
DEAR READER: Whooping cough (pertussis) is a highly contagious bacterial respiratory infection. During the first half of the 20th century, before the vaccine was created, pertussis was the leading cause of childhood illness and death in the US. After the vaccine became part of the normal childhood vaccinations, incidence of the disease gradually declined and hit an all-time low in the mid-1970s. Unfortunately, rates are again on the rise. Individuals can be re-infected, sometimes with years between, but if vaccinated and followed with regular boosters, it is less likely.
Those primarily affected are children under the age of six months, teens and adults. This is for two reasons. Initially, infants do not achieve full immunity until the 3rd dose which is given at age six months. The second reason is that around age 11, immunity begins to wear off. Many receive a booster shot at this age but it will again fade, leaving the individual susceptible during an outbreak. There is a 10-year booster vaccination known as tetanus/diptheria/pertussis (Tdap) which is available.
Whooping cough is so named because of its characteristic “whooping” sound (from a sharp, high-pitched intake of breath) following prolonged, severe bouts of coughing; however, many individuals don’t develop this sign. Symptoms ordinarily appear three to 12 days after exposure and resemble those of the common cold. They include a runny nose, mild fever, dry cough, congestion, sneezing and red, watery eyes. However, unlike a cold, these do not fade and within a week or two the coughing will worsen. Coughing fits will become severe and prolonged, may provoke vomiting, cause extreme fatigue, bring up thick phlegm, the “whoop” may develop and the face may turn red or blue during coughing.
Complications from coughing can occur. In infants and young children these tend to be more severe and may be life-threatening to include brain damage, seizures, slowed or ceased breathing, pneumonia, ear infections and dehydration. In adults complications are related to the severity of coughing and may include broken blood vessels in the skin or whites of the eyes, abdominal hernias, and cracked or bruised ribs.
Infants and young children are typically hospitalized once diagnosed because of the increased risk of complications and higher incidence of severity. They may receive IV fluids if food and liquids cannot be kept down; sedatives may be given to aid sleep.
Older children, teens and adults can typically recover at home safely. Treatment involves getting plenty of rest and fluids, using a humidifier to help ease coughing, and eating smaller meals if vomiting is problematic.
I suggest you and your husband speak to your physician(s) regarding immunization and/or booster shots. He or she will be better able to explain the benefits, risks and probability of infection or re-infection.
