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Long Beach experiencing a spike in whooping cough cases

Since the first of the year, 43 cases of whooping cough have occurred in Long Beach, compared to 15 cases for all of 2013
Since the first of the year, 43 cases of whooping cough have occurred in Long Beach, compared to 15 cases for all of 2013
Robin Wulffson, MD

On April 22 by the Long Beach Health & Human Services Department dispatched an alert to warn of rising whooping cough (pertussis) cases. Since the first of the year, 43 cases of whooping cough have occurred in Long Beach, compared to 15 cases for all of 2013. In addition, another case was recorded since the release of the alert.

“The concern is that this is a significant increase,” noted city Health Officer Dr. Mitchell Kushner. The majority of the cases are among school-age children and, to date, none have been fatal. Long Beach Health officials note that this year’s rise in cases may be the result of such factors as school-age children and adolescents not receiving the recommended booster shots for whooping cough immunizations. A contributing factor may be that young people who become ill with whooping cough may be returning to school too quickly after receiving medical care for their infection or not receiving care in a timely manner. Kushner said, “Kids are going to school with a persistent cough, and just thinking it’s a cold or just a bad cough.”

Whooping cough, or pertussis, is very contagious and primarily affects infants and young children. Whooping cough is caused by a bacterium called Bordetella pertussis. The illness is characterized by paroxysms (intense spells) of coughing that end with a characteristic “whoop” as air is inhaled. Whooping cough caused thousands of deaths in the 1930s and 1940s. With the advent of a vaccine, the death rate has declined dramatically. Pertussis vaccines are very effective. However, if pertussis is circulating in the community, there is a possibility that even a fully vaccinated person could catch the disease. Babies who are too young to receive the vaccine are also at very high risk of catching pertussis. The illness can be very serious, even sometimes fatal, in young infants. Many babies infected with pertussis have caught it from an adult.

Whooping cough initially has symptoms similar to the common cold, with a runny nose or congestion, sneezing, and sometimes a mild cough or fever. Usually, after one to two weeks, severe coughing begins. The following are the most common symptoms of whooping cough. However, each individual may experience symptoms differently. Infants younger than age six months may not have a classic whooping cough, or it may be difficult to hear. Instead of coughing, infants may have a pause in their breathing, called apnea, which is very serious. You should consult your healthcare provider or call 911 if you observe pauses in breathing.

Symptoms of whooping cough may include:

  • Coughing, violently and rapidly, until all the air has left the lungs and a person is forced to inhale, causing a “whooping” sound
  • Sneezing
  • Nasal discharge
  • Fever
  • Sore, watery eyes
  • Lips, tongue, and nailbeds may turn blue during coughing spells
  • Whooping cough can last up to 10 weeks and can lead to pneumonia and other complications.
  • The symptoms of whooping cough may resemble other medical conditions. Always consult your health care provider for a diagnosis.

In addition to a complete medical history and medical examination, diagnosis of whooping cough is often confirmed with a culture taken from the nose. Specific treatment for whooping cough will be determined by a physician, based on:

  • One’s overall health and medical history
  • Extent of the condition
  • Tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Parent’s opinion or preference (or patient, in cases of older children or adults)

Antibiotics are typically given within three weeks of the onset of cough in babies over age one year, and within six weeks of the onset of cough in infants younger than one year. Antibiotics are also given to pregnant women within six weeks of the onset of cough. Antibiotics help to prevent the spread of infection after five days of treatment. Other treatment may include:

  • Keeping warm
  • Eating small, frequent meals
  • Drinking plenty of fluids
  • Reducing stimuli that may provoke coughing
  • Hospitalization may be required in severe cases