• woman coughing
    Infectious Diseases

    Whooping Cough Outbreaks: Mayo Clinic Expert Discusses Causes, Prevention

ROCHESTER, Minn. — Whooping cough, or pertussis, is making headlines, nearly all of them bad news. At least 18 children have died in recent months in what the U.S. government calls the highest infection rate in 70 years. And the problem is global, with similarly increasing rates reported overseas. While preventing the disease is in part up to medical experts, everyone can take some basic steps, such as getting vaccinated and staying home when ill, says
Gregory Poland, M.D., an infectious diseases expert and advisor to the Centers for Disease Control and Prevention.

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Pertussis is a contagious respiratory disease that is particularly difficult for infants, young children, pregnant women and the elderly, but can affect anyone. The characteristic "whoop" occurs about two weeks after what appear to be cold symptoms. The whoop refers not to the actual barking cough, but to the intake of air after the cough.

"In the U.S., well over 18,000 cases have now been documented — outbreaks larger in scope than in the last 50 or more years — and these are certainly just the tip of the iceberg," says Dr. Poland.

If not recognized and treated, pertussis may provoke severe headaches, vomiting, extreme fatigue, chronic coughing for up to three months and in extreme cases broken ribs and other serious consequences. If you hear the whooping sound or experience vomiting along with these symptoms, you should seek medical help.

Dr. Poland says a range of factors could be causing this year's upsurge in whooping cough — in some cases a 1,000 percent increase over two years ago.

Dr. Poland, also editor of the journal Vaccine, recently published a commentary highlighting the possibilities, including:

  • Waning immunity of the vaccine, especially in adolescents and adults.
  • Possible skewing of pertussis immune responses in children due to use of a subunit vaccine in early childhood.
  • Possible vaccine-resistant strains.
  • Inadequate and confusing immunization recommendations and guidelines.
  • Lack of awareness of need for tetanus, diphtheria, and pertussis vaccination.
  • Unprecedented global travel and interaction.
  • Improper handling of the vaccine.

"What we may have to do in the future is look at increasing the frequency for vaccinating adults. Right now, the recommendation (other than for pregnant women) is to receive only one (pertussis) vaccine in their lifetime," says Dr. Poland.

To interview Dr. Poland about likely causes, upcoming developments and recommendations for resolving the pertussis crisis, please contact Robert Nellis in Mayo Clinic Public Affairs at 507-284-5005 or newsbureau@mayo.edu.

Media Contact: Robert Nellis, 507-284-5005 (days), newsbureau@mayo.edu