The first time I heard about someone I knew coming down with Whooping Cough, properly known as Pertussis, was several years ago. A friend from an online parenting group I belonged to had been quite sick. After numerous trips to the doctor, countless sleepless nights, and no noticeable improvement, she was finally diagnosed with Whooping Cough. Of course, by that point she'd long passed the early stages of the illness where antibiotics might have helped her, and there was nothing much to be done but to ride it out, and hope that she hadn't spread it too far.
The next friend to come down with it got sick a few years later. She works with kids and, like my first friend, she went back and forth with the doctors, getting sicker and sicker with no explanation for some time. Like most people (and especially those who work with kids) she was up-to-date on all her shots, and so no one tested her for Whooping Cough for many weeks. Like my first friend, even after diagnosis she lived in misery for many, many weeks recuperating.
When Ellie was in preschool, there was been an outbreak in the school. At the time, I asked the nurse if she knew whether or not the kids diagnosed had been up to date on their shots, and she assured me that they all were. Interesting.
Then last year, at the beginning of Christmas break, I received a call from the state health board. It seems that someone who worked closely with Ellie at school was suspected of having Whooping Cough, and they were alerting me that Ellie might have been exposed. This nurse and I spoke at some length, as I had several questions. I was pretty sure I knew who the person was (the poor woman had been ill for most of the fall and had said that she couldn't sleep for the coughing) and I knew that, like my other friends, she'd had a hard time getting help from doctors. Given how long she'd been sick before I was contacted, she'd suffered a long time before getting tested.
I told the nurse about the school outbreak a few years prior, and about all the kids being up-to-date, and asked her about the vaccine failure rates for pertussis. She said that our state has high levels of vaccination, but that they now see a lot of Whooping Cough in vaccinated people. When they first started to see it in vaccinated people, she said, they thought there'd been a bad batch of vaccines, and they'd tracked down all the lot numbers. But they were different batches, and no apparent connection between them. She said they weren't sure it if was because the vaccine wasn't as effective as they'd thought, or the bacteria had mutated*, but something had certainly changed. Since then, they've seen it more and more, and now they recommended people get tested, regardless of vaccine status. Somehow, I doubted that information was making it into the doctors' offices, but she said she didn't know how often doctors were actually testing people, especially adults, with bad coughs for pertussis. I think that they have to be sick for many, many weeks before the testing is done.
Fast-forward to this year. In January, Spencer came down with a chest cold. It seemed to be the same one that had gone through my extended family, and sure enough, after about 10 days it started to clear up. Then Ellie started getting symptoms. Naturally, I assumed she was just the next in line.
I kept her home for a few days because she was tired, and her nose was running. Then the fatigue and runny nose lifted, and she went back to school, but her occasional cough was getting worse. Wet and chesty. It made her gag a little, and she couldn't clear it the way Spencer could. Still, she had no fever, she seemed to feel fine and act like her usual self. She was sleeping fine. We pushed fluids, and she had an outstanding week at school. They said her cough sounded bad, but that she was in good spirits and she was "super student" all week, which meant her behavior and work were great. At pick-up on Thursday that week one teacher told me that her daughter had coughed for over 8 weeks- that it was going around. Another said that Ellie sounded just like her - she'd been fighting a cough for weeks and had missed school because she was so tired from coughing. She figured Ellie was two weeks behind her in the illness.
This information caught my ear because it reminded me of what I'd learned before - about how easy it was for adults to have Whooping Cough and not be tested, not to know. Coughs for weeks or months are not typical of a cold or flu.
That night the cough woke Ellie up more than once. She coughed, gagged, and threw up mucous. I was officially concerned. I kept her home the next day to watch her. Still, she behaved normally, but the cough was worse.
Saturday morning she had an especially bad cough and couldn't catch her breath. She was gagging and spitting out lots of goo. I googled videos of kids with Whooping Cough and got a knot in my stomach. They sounded like Ellie. I called the pediatrician's office and talked to a nurse, who reassured me that there were lots of nasty respiratory bugs going around, and there was no reason not to watch and wait a bit. It was clear she thought I was over-reacting; after all, she had only been coughing for a week! She was probably just having a hard time with the congestion.
Sunday morning, after another bad night, I called and scheduled an appointment with the doctor. I told them I wanted her to be tested for pertussis. When I got off the phone, I waited for her next cough, and I took a video of the whole thing for the doctor to see. I wasn't sure she'd cough for them, and if she didn't, I was concerned that they'd tell me to wait again.
It's a good thing that I did. All my explanations of what was happening simply netted me the usual, calming doctor nod - you know the one that says "There, there, worry-wart mother. Of course, there's nothing to worry about here. Don't get hysterical." He checked her vitals, asked her questions, and said she looked ok.
Then I showed him my video. That was when he started to take me seriously.
Suddenly, he agreed that this could be pertussis. He got a nurse to prep a test, and started to talk about antibiotics. I told him that there were two other kids at home, and urged him to proscribe antibiotics for them, too. At first he wanted to wait for the test results to come back, but I pushed. If we waited, wouldn't we be letting them be exposed longer, and possibly get sick or sicker themselves? How long should we wait, when we know that the antibiotics are most useful in the early stages of contagion? He had to admit that starting earlier was better with pertussis, and the test could take days to come back. He proscribed Z-Pacs for all three of them, and recommended that my husband and I get them from our doctors, too.
As I'm sure you've surmised, she did in fact have pertussis, contracted no doubt from someone who had no idea they were infected. Someone who didn't know they were vulnerable. Someone whose doctor had assured them it was just a bad cold. Even my husband, who went in to the doctor with a cough and asked to be tested because of Ellie's diagnosis, was met with resistance from the doctor's office. They never see pertussis, they said. It just sounded like a cold- they were seeing lots of those. It's only because he insisted, and reminded them that Ellie had it, that they agreed to test him. And yes, he had it, too.
Starting antibiotics early is KEY. Starting when we did stopped Ellie's case from getting any worse than it was, which was bad enough. She's been coughing for 2 weeks now, and some nights have been brutal. At its peak, she was waking every hour at night to cough and gag. It was pitiful and rough. But because we caught it early, she's already improving. She's coughing very little during the day, and much less at night. Last night, we got almost seven consecutive hours of sleep! It's likely to be a slow road back to complete health, but at least we got an early start.
And because my husband got tested and started on antibiotics, his illness never progressed to then gagging, rib-breaking cough, but stopped with the wet chesty cough. Spencer and I never got anything (which is miraculous since she was in my face all the time) and Lexi only got a dry, hacking cough. It could have been so much worse. Another week or two, and we could have all been sick, and Ellie would have been beyond the point where antibiotics could have helped her at all.
I'm sharing this in the hope that more people will be aware and educate themselves about this. Be the best advocate you can for yourselves and your kids. Take the time to google it to see and hear what this cough looks like, and push for testing and treatment early if you suspect you have it. Be on alert if a friend or associate or family member says they're exhausted and they've been coughing for weeks. It's out there, and any of us can get it!
*Note: As of 2013, according to the CDC, there is a strain of Pertussis in circulation that has indeed mutated, and seems to have actually been more successful in infecting those who have received the DTaP vaccine. This may mean that being up-to-date can make you more susceptible to this particular type of pertussis infection. If this is confusing you, join the club! The notes regarding this mutation can be found on page 6 of this PDF from the CDC: Meeti ng of the Board of Scientific Counselors, Office of Infectious Diseases
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