What Older Adults Need to Know About Whooping Cough

Cases are five times as high this year compared with last, federal data shows

Rachel Nania,

AARP

Comments

En español

Published June 14, 2024

/ Updated September 24, 2024

a man suffering from whooping cough against an illustrative background of blue bacteria

AARP (Source: Getty Images(2))

When it comes to respiratory illnesses, COVID-19, flu and RSV often demand the spotlight. However, a lesser known condition is catching the attention of health authorities and prompting reminders about the importance of prevention and vigilance.

Roughly five times as many cases of pertussis, more commonly called whooping cough, have been reported this year compared with last. From January to mid-September, the U.S. logged 14,569 cases of whooping cough, according to preliminary data from the Centers for Disease Control and Prevention (CDC). In 2023, there were 3,475 cases by Sept. 14. Robert H. Hopkins Jr., medical director of the National Foundation for Infectious Diseases, suspects a combination of factors behind the swell in cases — “what I might call a perfect storm of a vaccine preventable disease resurgence,” he says.

Routine vaccinations among children have declined since the start of the COVID-19 pandemic, which could explain an increase in infections. (There’s a pertussis vaccine recommended in early childhood and a booster given at various stages of life.)

“We’ve seen the reemergence of diseases that we shouldn’t be seeing with the safe and effective vaccines we have to protect our population,” Hopkins says.

Post-pandemic social patterns may also be at play, says Graham Snyder, medical director of infection prevention and hospital epidemiology at UPMC and an associate professor at the University of Pittsburgh School of Medicine. “Maybe we’re catching up on social activities, maybe we’re more likely to travel than we were pre-pandemic because we had a couple of years where we were missing those activities,” he says.

Regardless of the reason, experts say older adults should remain alert. Although it’s often thought of as an illness that affects babies, whooping cough can be dangerous in adults as well. “[It’s] one that I think is under-recognized and underappreciated as a cause for problems in our adult population in particular,” Hopkins says.

Here’s what you need to know.

How is it spread?

Whooping cough is caused by a bacterium, called Bordetella pertussis, that spreads easily from person to person by way of small respiratory droplets (from coughing or sneezing) in the air. A person infected with the bacteria can spread it to others for several weeks, the CDC says.

What are the symptoms?

It can take a few weeks after you’re infected to develop symptoms. Once you do, it can be difficult to separate them from symptoms of other common illnesses.

At first, the infection may feel like a cold. “It’s a runny nose at first, it’s a mild cough. You may even have a low-grade fever,” Snyder says. “The differentiator, though, is the cough. Over the next one to two weeks of those first symptoms, the cough will get worse and worse.”

Eventually, many people experience coughing fits that leave them struggling to breathe. (Whooping cough gets its name from the “whoop” noise people make when inhaling and gasping for air after a coughing fit.)

These fits can be violent enough to cause someone to throw up, break a rib or puncture a lung. To make matters worse, they’re not short-lived. According to the CDC, the coughing fits usually last one to six weeks but can persist for up to 10. “It’s pretty darn miserable,” Hopkins says.

The pertussis vaccine, invented in 1914, has made serious complications from whooping cough less likely. However, they can still occur — particularly in people who are frail or have underlying respiratory conditions, Snyder says. Complications can include pneumonia, trouble breathing and severe dehydration. Some people can even suffer from brain bleeds “as a result of the pressures from that severe coughing,” Snyder says.

How is it treated?

Because whooping cough is caused by bacteria, antibiotics can help treat it. Antibiotics won’t resolve symptoms completely, but if given early — before the coughing fits begin — they may make the infection less serious, the CDC says. If they are started too late in the illness, after about three weeks, they are unlikely to help. “By then, the infection is gone (the bacteria aren’t in the body any longer),” the CDC says, and “the ongoing symptoms are because the airways were damaged and take time to fully heal.”

Another benefit to the antibiotics is that they can cut down on the spread of the illness. “You may reduce how contagious you are to others,” Snyder says. If you live with others and develop whooping cough, members of the household might also be prescribed antibiotics to keep them from getting sick.

How can you prevent it?

First, make sure you’re vaccinated. The vaccine is recommended at various points in life. Babies and children are given the vaccine; so are pregnant women. If you’re unsure about your vaccination status, talk to your doctor.

Adults can get a booster dose of the vaccine every 10 years with the Tdap shot, which protects against tetanus, diphtheria and whooping cough. If you have a new grandchild coming, that’s another opportunity to get a Tdap vaccine, Hopkins says.

Beyond the vaccine, you’ll want to do “the same things that we do to try to prevent spread of any respiratory pathogen,” Hopkins says. Stay home when you are sick, and if you are worried about your risks for whooping cough, wear a mask in crowded public spaces.

Hopkins says a bump in whooping cough cases is typical in the fall and winter. We’re seeing a trend at a time of year “when we don’t expect to see as much whooping cough.” He adds that whooping cough is often underreported and undertested. “So the numbers that we’re seeing are probably really more of a tip of the iceberg than the actual amount of disease in the communities,” he says.

Editor's note: This story, originally published June 14, 2024, has been updated.

%{postComment}%