Flu Season Symptoms

Mar 19, 2020

Our Guide to Care

We recently wrote on here about the comeback of measles. Well, there’s another infectious disease from days of yore that is clawing its way back into the limelight. And that’s pertussis, AKA “whooping cough.” Even though it sounds like something from Oregon Trail, it’s real, and its hanging around.

Just like Holly Hunter’s character in Raising Arizona, we all know how important the “Dip-Tet” is. “Dip-tet” is how they used to refer to the vaccine that prevents pertussis. Nowadays, the shot combines the vaccines for diptheria, tetanus, and pertussis, and is administered to kids at age 6-8 weeks of life with four doses administered over the first two years.

The crazy thing is that this vaccine is only thought to confer immunity for around three to six years. This is great for the babies getting the shot, since they are the ones who are most susceptible to serious complications (and even death, yikes) from pertussis. The vaccines are often referred to as DTaP for infants and babies. Preteens, teens, and adults get a version that is called Tdap.

The CDC recommends only testing patients in whom there is a high clinical suspicion of pertussis. And they do not recommending testing asymptomatic contacts of the patient.

We recently wrote on here about the comeback of measles. Well, there’s another infectious disease from days of yore that is clawing its way back into the limelight. And that’s pertussis, AKA “whooping cough.” Even though it sounds like something from Oregon Trail, it’s real, and its hanging around.

More to Know

The infection begins with what is called the catarrhal phase. This looks essentially like the common cold with runny nose, cough, and low-grade fever. After 1-2 weeks, the infection progresses to what’s called the paroxysmal phase. This phase is characterized by severe paroxysms (or bursts) of numerous, rapid coughs. This can be followed by a sharp inspiration leading to a “whooping” sound. Often these fits can lead to vomiting, and severe exhaustion. Yet between the episodes, the patient may appear completely normal, which can lead to delays in diagnosis. This paroxysmal phase can last anywhere from one to six weeks, and then the infection moves to what is called the convalescent phase – a gradual recovery over two to three weeks.

One of the things that makes diagnosis tricky is that adolescents and adults who have been immunized can still get the infection, but display milder symptoms. They may not have the classic inspiratory whoop. Clinicians should consider pertussis in anyone presenting with at least two weeks of cough.

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