Whooping Cough vs. "Chest cold"

Okay. Questions for the local medics.

I’ve had a “chest cold” for over a week. Mild congestion in the sinuses, but mostly just a deep cough which generally doesn’t produce any fruitful results i.e. pleghm. The cough most just aggravates and irritates my chest/lungs. I recently found out that numerous cases of Whooping Cough have been reported in the city I live in.
Yesterday I had that chilly/aching feeling in my joints and bones that generally signals the onset of major illness or fever. Sure enough, last night I developed a high fever which quickly broke. In the midst of the fever, I made an appointment with a doctor for today (a visit I can’t really afford right now…). Now that my fever has broken, I feel much better. Congestion is less and I only have an occasional mild urge to cough.

Should I still see the doctor? Can my illness have passed? I may have had some contact with someone with Whooping Cough. Is it dangerous, and can I have overcome it without medical attention already?

You never got a vaccination for pertussis? I would think that if you had a high fever accompanied by a cough and breathing problems, I would splurge and go to the doctor.

I would worry a lot more about having pneumonia than whooping cough.

Did you “whoop” when you coughed? Also, how old are you? Under-15? 15-20? Over-20?

Reason I ask…
http://kidshealth.org/parent/infections/bacterial_viral/whooping_cough.html

Also…

I, too, would worry more about pneumonia than whooping cough, although the chance that you may be spreading whooping cough bacteria to those around you would be, in my mind, good enough reason to have a doctor check it out.

You live with anybody? Have friends, family, co-workers? Cough in their faces recently?

I had whooping cough in junior high (apparently, my immunization was from a bad batch). You should see your doctor. It took about four weeks to diagnose mine (since they had ruled it out due to my immunization), and then another six weeks to recover enough to be able to go to school. I was weak for another six weeks after that. If you may have whooping cough, it should be taken seriously and treated promptly.

Are you “whooping” after you cough? (Basically, you cough all the air out of your lungs, and keep coughing. When you stop coughing, you still can’t really get any air into your lungs, and you make these whistling, gasping sounds as you try, generally swallowing a bunch of air. Once the blockage breaks and you can breathe again, you either belch or throw up due to the swallowed air. It really sucks).

If you want to hear what whooping sounds like, go here there are sound files. (As well as a description of typical symptoms)

(A warning though, you may find the sound files of the children whooping a bit disturbing. )

The advent of routine vaccination of children with pertussis antigen-containing vaccines over 50 years ago changed whooping cough (pertussis) from a common disease and frequent killer to an uncommon disease and rare killer (about a dozen deaths attributed to pertussis each year in the U.S.). Nevertheless, pertussis is still with us and the numbers of cases reported each year have been going up gradually over the past decade or two. This year there have been a lot of outbreaks (although probably not more disease than last year) and this is the reason there have been so many newspaper articles about pertussis.

The vaccine is a terrific life saver but it is not perfect. It is only 80% effective in preventing moderate to severe disease in the kids for whom it recommended. More important, it is not recommended in the U.S. for people < 6 weeks or over the age of 6 years of age, which means that the smallest infants remain unprotected until they get their first few shots (given at 2, 4, and 6 months of age normally) and that older children and adults are unprotected since the vaccine’s protective effects wane after 5-10 years.

It used to be thought of as a childhood disease and, indeed, most cases are reported in children, especially young infants who are the most likely to have severe disease requiring hospitalization. But reporting is very poor. Most cases probably aren’t recognized and certainly most cases aren’t definitively diagnosed because sensitive tests for pertussis are not generally available. Some recent studies of adults have shown that a lot (10-20%) of adults with persistent cough have pertussis so it is probably way more common than we think.

The thing about pertussis is that often it causes a cough that is distinctive, not just a week of sniffles and fever. The cough tends to last a long time (e.g., the “100 day cough”), it is typically paroxysmal (comes in “fits”), the paroxysms often end in vomiting or whoops. A few percent of adults cough so hard they break their ribs and something like 20% of adult women in one study experienced urinary incontinence.

ENugent’s description of the symptoms sounds typical but I feel a need to comment on the the first paragraph of the posting: (1) It’s not uncommon for kids in junior high to get pertussis since that’s about the time their last vaccination wears off. (2) It’s very unlikely that ENugent received vaccine from a bad batch. (3) It’s not uncommon for pertussis to go undiagnosed for a long time unless there is an outbreak going on when people think everything is pertussis. It is possible that it was diagnosed after 4 weeks because in MA they use a serological test for diagnosis which involves measuring antibodies to pertussis antigens that only develop weeks after the disease starts, (4) Pertussis is not treated to relieve the symptoms because antibiotics don’t have much effect. The reason for giving antibiotics to infected people is so that they won’t pass on the disease to others.

The most important thing to remember about pertussis is that infants, who can die from it, should be vaccinated on time at 2, 4, and 6 months and that all young infants should be kept away from anyone with a cough or cold symptoms.

Could you give a cite? I’d be interested to read those studies.

Senzilet LD, Halperin SA, Spika JS, Alagaratnam M, Morris A, Smith B; Sentinel Health Unit Surveillance System Pertussis Working Group. Pertussis is a frequent cause of prolonged cough illness in adults and adolescents. Clin Infect Dis. 2001 Jun 15;32(12):1691-7. Epub 2001 May 21.

Birkebaek NH, Kristiansen M, Seefeldt T, Degn J, Moller A, Heron I, Andersen PL, Moller JK, Ostergard L. Bordetella pertussis and chronic cough in adults. Clin Infect Dis. 1999 Nov;29(5):1239-42.

Sometimes you can have WC and not whoop, though. My daughter had it as a baby and didn’t whoop, just had the nonstop coughing. Getting in a shower helps, the steam is relaxing.

Thanks for the clarifications. My doctor at the time believed that I had received a “bad” vaccine, because there was an epidemic of pertussis going on at the time in Cincinnati, where I was vaccinated, but as you will see below, he may not have been particularly “up” on pertussis. I was living in California, not Massachusetts, when I contracted it - I came out here for college and never left.

I don’t think it was diagnosed serologically. In fact, I never coughed in the doctor’s office for the first several visits (probably because it was so clean). I’m pretty sure he thought my mother was just being neurotic about a cold, until the day when I finally had a coughing fit in his office. He stopped in the middle of writing in my chart, turned to my mother, and said “that’s what she’s been doing?” I had a chest X-ray that afternoon, and they settled on the diagnosis of pertussis on the basis of the persistent whooping and the X-ray.

My memory is that I had relief of symptoms a few days after the start of the antibiotics, but I suppose that could have been coincidental.