Whooping cough is a disease that has been described since antiquity. It happens to be the most common vaccine preventable disease in the world, yet it has seen a dramatic resurgence in the United States in the last several years. In 2014 the United States saw the greatest number of whooping cough cases in more than 50 years. Multiple states have seen major outbreaks with frequent infant deaths. The disease itself is under-diagnosed, and treatments have focused on controlling the spread of this disease without much impact on the course of the disease. Infants who have not completed their primary vaccinations make up the group with the most complications, hospitalizations and deaths.
The current childhood vaccinations with newer, so-called “cellular” vaccines do not provide lifelong protection. As the immunity of adults wanes, they become susceptible to the disease and are also a source of infection of infants who are unprotected. Whooping cough is caused by a specific bacteria which is difficult to culture. A specific test called PCR looks for the genetic marker of this disease but this test is often not considered in the adult population where the clinical symptoms may be less intense than the infant counterparts. Specific antibiotic therapy targeting the whooping cough bacteria is usually successful in resolving the infection, but as with most infections, prevention remains the main way of controlling the disease. The older vaccinations (remember the DPT’s) seem to have been more successful in providing immunity but with potentially more side effects.
