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Whooping Cough
(Pertussis)

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Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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What is whooping cough? What is the history of whooping cough?

The disease is named for the characteristic sound produced when affected individuals attempt to inhale; the whoop originates from the inflammation and swelling of the laryngeal structures that vibrate when there is a rapid inflow of air during inspiration. The first outbreaks of whooping cough were described in the 16th century. The bacterium responsible for the infection, Bordetella pertussis, was not identified until 1906. In the prevaccination era (during the 1920s and 30s), there were over 250,000 cases of whooping cough per year in the U.S., with up to 9,000 deaths. In the 1940s, the pertussis vaccine, combined with diphtheria and tetanus toxoids (DTP), was introduced. By 1976, the incidence of whooping cough in the U.S. had decreased by over 99%.

During the 1980s, however, the incidence of whooping cough began to increase and has risen steadily, with epidemics typically occurring every three to five years in the U.S. In the last epidemic, which occurred in 2005, 25,616 cases were reported according to the U.S. Centers for Disease Control and Prevention (CDC). In 2008, over 13,000 cases of whooping cough were reported in the U.S., resulting in 18 deaths.

In 2010, a pertussis epidemic was declared in California. The California Department of Public Health warned in June 2010 that the state was on pace to suffer the most illnesses and deaths due to whooping cough in the past 50 years. In the previous epidemic of 2005, California recorded 3,182 cases and eight deaths.

Unimmunized or incompletely immunized young infants are particularly vulnerable to the infection and its complications, which can include pneumonia and seizures.

Can whooping cough be prevented with a vaccine?

Whooping cough commonly affects infants and young children but can be prevented by immunization with pertussis vaccine. Pertussis vaccine is most commonly given in combination with the vaccines for diphtheria and tetanus. (Pertussis is the "P" in the DTaP combination inoculation routinely given to children, and the "p" in the Tdap vaccine administered to adolescents and adults.) Since immunity from the pertussis vaccine wears off with time, many teenagers and adults get whooping cough.

For maximum protection against pertussis, children need five DTaP shots. The first three vaccinations are given at 2, 4, and 6 months of age. The fourth vaccination is given between 15 and 18 months of age, and a fifth is given when a child enters school, at 4-6 years of age. Preteens going to the doctor for their regular checkup at 11 or 12 years of age should get a dose of the Tdap booster, and adults who didn't get Tdap as a preteen or teen should get one dose of Tdap. The easiest way for adults to ensure immunity is to get the Tdap vaccine instead of their next regular tetanus booster. (The Td shot is recommended every 10 years.)

To protect their infants, most pregnant women who were not previously vaccinated with Tdap should get one dose of Tdap postpartum before leaving the hospital or birthing center. Getting vaccinated with Tdap is especially important for mothers and families with new infants as well as all people caring for newborns. Women planning pregnancy may also choose to get vaccinated with Tdap prior to becoming pregnant.

In some cases, pregnant women may desire vaccination with the Tdap vaccine or may be at risk for acquiring whooping cough. Although the U.S. CDC states that pregnancy is not a contraindication for receiving the Tdap vaccine, data on the safety of the vaccine in pregnant women are limited. The tetanus and diphtheria (Td) components of the vaccine are considered safe for pregnant women. If the Tdap vaccine is given in pregnancy, the CDC recommends that it be given in the second or third trimester. Pregnant women should consult their health-care provider for a discussion their individual situation regarding the pertussis vaccine.