What whooping cough is, looks like, and sounds like

Whooping cough, or pertussis, its official medical name, is one of those things we hear our grandparents talk about. It once made many, many infants extremely sick with severe coughing and excessive mucous, and some died from it. The so-called paroxysms of coughing can end with the infant sputtering and blue at the end of the spell, after which he takes a huge gulp of air — the characteristic “whoop.” They tire themselves out so much from coughing that they have little energy left to do anything else, including eating.

We have a vaccine that does a fairly good job of preventing whooping cough, which is why we don’t see much of it these days. But the illness has not gone away. In fact, I saw several cases this past winter, one of the many I’ve seen over the years, and there was a recent epidemic from it in California in which several children died. This epidemic was caused by the drop in vaccination rates. That drop came from parents understandable, but misplaced fears over the vaccine. (You can read several well balanced essays about that over at Dr. Wendy Swanson’s (Seattlemamadoc) blog here, here, and here. The comments are particularly useful in understanding the issue.)

The protection the vaccine gives tends to fade with age, and studies have shown that a fair number of adults with a persistent, chronic cough actually have infection with the pertussis bacteria that causes whooping cough. If such people come in contact with young infants, typically before those infants have completed (or even received) their vaccinations, the babies can get the infection. This is why adolescents and adults exposed to infants should get a Tdap booster.

I’ve seen some very severe examples of what can happen then. I described one of these in my first book.

The infection affects children in several ways. Our respiratory tract normally produces mucous every day. This is one of the key ways we protect our lungs from all of the particles in the air, such as dirt, pollen, and dust. When we breathe these particles in, they are trapped by the mucous in our airways, and we then cough the material out, which is why our phlegm looks dark after we have been in a dusty environment. The whooping cough bacteria increase the amount of mucous in the infected child’s airway. In addition to that, the bacteria interfere with how the lungs normally get mucous up from the small airways to cough it out. The result is that a child with whooping couch is nearly drowning and gasping for air between coughs; this gasp at the end of a coughing spell is the “whoop” of whooping cough.

If you are interested in finding out more about this infection, you can find it here and here. If you’re interested in hearing exactly what whooping cough sounds like, there’s a new clip up on YouTube here. It’s an excellent example.