Whooping Cough - Prevention

Dr. Parang Mehta, MD.

Whooping cough is a highly infectious disease, with a secondary attack rate of 97%. This means that almost all susceptible people exposed to a person with whooping cough will go on to develop the disease.

Who's not susceptible? If someone has had whooping cough recently, or been vaccinated recently, they're immune. Immunity to whooping cough is not lifelong. It starts waning after 5 years, and is almost non-existent after 12 years. In countries where this disease is common, people keep getting the infection, and this keeps boosting their immunity. In countries like America, where the disease is rare, most adolescents and adults are sysceptible to whooping cough.

It is well to remember that it was the most common infectious disease cause of death in children, before vaccination was introduced. Measures to prevent spread of the disease from persons with whooping cough, as well as vaccination of children with the vaccine, continue to be important.

Preventing Whooping Cough Spread

Children with whooping cough should be isolated, to prevent spread of the disease to other children in school and daycare. Keeping other children in the home is more difficult -- they can be protected by giving protective antibiotics (see sidebar).

Isolation is needed till the child is infective. If antibiotics (usually erythromycin) have been prescribed, the child is non-infective after 5 days, and isolation can be relaxed.

Whooping Cough Vaccination

Whooping cough (Pertussis) vaccination is a part of the childhood vaccinaiton schedule in almost all countries, though the timing and number of doses differ. It is usually given combined with the tetanus and diphtheria vaccines, as the DTP vaccine. Three doses are given in the first month, starting at 6-8 weeks of age, at intervals of 4-8 weeks. Two boosters are generally recommended, one each in the second and fifth year.

Whooping cough vaccination is often associated with side effects, mostly pain, swelling, and redness at the injection site. This can last up to 24 hours, and is more severe with the boosters in the second and fifth years. It can be treated with fever and pain medicines. Other side effects are high fever, seizures, excessive crying, and a limp unresponsive state after the injection. The last three are contraindications for further doses of this vaccine.

Two types of pertussis vaccines are available. The older, whole cell vaccine, has been in use for many decades. The newer one, called acellular partussis vaccine, is a recent introduction. Combinations of the whole cell vaccine with diphtheria and tetanus vaccines are called DTP or DTwP, combinations of the acellular vaccine are called DTaP.

Acellular pertussis vaccine is not more effective than the whole cell vaccine, but it has fewer side effects.

The DTP vaccine is often combined with other vaccines such as hepatitis B and hemophilus influenzae type b vaccines. While the whole cell vaccine in combination causes no problems, it has been found that the effect of the other vaccines is reduced when combined with the acellular pertussis vaccine.

Whooping cough (Pertussis)

 

Last revision: September 16, 2011

Met Someone With Whooping Cough?

Whooping cough is both highly infectious and troublesome. Persons who have this disease cough a lot, spreading the bacteria in cough droplets into the air. Any child who has come in close contact with an affected person (home, school, creche, daycare, etc) is likely to be infected and get the disease.

Children who have received pertussis vaccine doses in the past, should have their series completed. However, even fully immunised children who come into contact with whooping cough at home, daycare, or school must be given protective antibiotics.

The usual recommendation is erythromycin for 2 weeks, because there is good evidence of its effectiveness. Other choices are azithromycin and clarithromycin.

Contact Information

Dr. Parang Mehta,
Mehta Childcare,
Opposite Putli, Sagrampura,
Surat. Tel: +91 98241 53923.
Email: