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When I was a toddler nearly 60 years ago, I survived a brush with whooping cough. Vaccination programs seemed to have made the once-deadly disease a thing of the past, but an unexpected failure of vaccination is allowing whooping cough to make a comeback.

Back in the 1950's, I came down with a really nasty infection I remember vividly, even though I was only about two years old. In the front room of my grandmother's house in Augusta, Georgia, I coughed and coughed and coughed, so sick that I had forgotten that Santa Claus was due to arrive any day. I don't know from my own recollection whether I "whooped," making the unmistakable sound of struggling to breath through passages that are partially closed, but I do know I had to stay by myself, away from my aunts and my uncles and my grandpa and my grandma until I got better.

I had whooping cough. Just a few years later, whooping cough became a memory as school children were required to take vaccinations to prevent the disease. However, in recent years  the sometimes deadly respiratory infection has made a resurgence as vaccinations are no longer completely effective.

What Is Whooping Cough?

Whooping cough, also known as pertussis, is an infection with the bacterium Bordetella pertussis or Bordetella parapertussis. This bacterium has to have oxygen to live, preferring lung tissue, and is "fastidious," meaning it is hard to grow in a test tube, and does not need to form a film with other bacteria to attach itself to the linings of the lung. This microbe causes whooping cough in humans and a disease called kennel cough in dogs. 

Whooping cough is extremely infectious. From 80 to 90% of people who are exposed to the germ develop the disease. Epidemics of whooping cough are most common in late summer to early winter, lingering longer in more southerly locations.

The Catarrhal Phase

The early stages of whooping cough are hard to distinguish from common cold. There can be runny nose, mucus under the eyelids, a slight fever, and sneezing. During this stage, the disease is particularly infectious, spread from person to person by contact with mucus or droplets in the air after a sneeze. The disease continues to be infectious for up to 3 weeks after cough has begun.

The Paroxysmal Phase

Several weeks after the infection becomes obvious, it may cause unremitting cough. In infants and toddlers the air passages are smaller, so that inflammation may cause them to partially close. Constant coughing leads to red eyes and exhaustion, and in the very young and, oddly enough, in adults aged 45 to 64, it may also cause pneumonia.

The Recovery Phase

After several weeks, constant cough stops, and frequent, dry, nonproductive cough may continue for several weeks more.

Who Gets Whooping Cough/Pertussis?

In the United States, pertussis used to strike about 250,000 people a year, killing about 10,000. After vaccinations became commonplace, the infection rate fell to as low as 1010 in 1976, but soared to 27,560 cases in 2010. Deaths from the disease in the twenty-first century are fewer, but the infection still strikes infants and toddlers (about 35% of cases in the US), children aged 7 to 10 (about 17% of cases in the US) who pick up the infection at school, and teens and adults of all ages. At least 90% of deaths from the disease occur in infants under the age of six months.

Continue reading after recommendations

  • Brown T. Pertussis vaccines: whole-cell more durable than acellular. Medscape Medical News [serial online]. May 22, 2013.
  • Walsh PF, Kimmel L, Feola M, Tran T, Lim C, De Salvia L, et al. Prevalence of Bordetella pertussis and Bordetella parapertussis in infants presenting to the emergency department with bronchiolitis. J Emerg Med. Mar 2011. 40(3):256-61.
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