Whooping Cough Explained

As of November 24, 2024, there have been three confirmed cases of whooping cough at Stuyvesant High School, sparking concern among students and parents alike. The news has left people wondering about the exact nature of the disease since it remains unknown to most. 

Whooping cough, also known as pertussis, is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. Although it was once a leading cause of childhood mortality, it is now largely preventable through vaccination. However, despite advances in medical science, whooping cough continues to afflict people around the world, including those at our school. 

Whooping cough is characterized by severe, rapid coughing fits that often end with a distinctive “whoop” sound when the person inhales after coughing. This sound is most noticeable in young children; infants and adults may not exhibit it. The infection begins when Bordetella pertussis invade the respiratory system through the air and attach themselves to airway linings. Once there, the bacteria release toxins that inflame and damage the respiratory tract. This damages the cilia—tiny hair-like structures—that normally help clear mucus from the lungs, which leads to a persistent and uncontrollable cough that can last for weeks or even months if not treated properly. 

Whooping cough develops in three stages, each with distinct symptoms. The first stage, known as the catarrhal stage, begins with symptoms that resemble those of the common cold such as mild coughing, a runny nose, and a low fever. During this stage, the infection is highly contagious, but symptoms are often mistaken for more typical respiratory infections like seasonal influenza or bronchitis. Whooping cough spreads easily from person to person through respiratory droplets when an infected person coughs, sneezes, or even talks.  

The second stage, known as the paroxysmal stage, is where the hallmark symptoms of whooping cough appear. It is marked by severe coughing fits, which are often accompanied by vomiting and difficulty breathing. These fits are followed by the characteristic “whooping” sound when the afflicted person gasps for air. This stage can last for weeks as the coughing fits become more and more intense. Infants are at greatest risk during this stage since they can experience apnea—pauses in breathing—which can lead to serious complications such as brain damage from lack of oxygen. 

The final stage, known as the convalescent stage, is the recovery phase. Although the coughing gradually becomes less severe, it can persist for several weeks while the body heals.  During this time, the person is less contagious but can still struggle with fatigue and discomfort from the lingering cough. 

While whooping cough is often mild in older children and adults, it can be life-threatening for infants and vulnerable individuals. Common side effects and complications in infants include pneumonia, seizures, and brain damage from oxygen deprivation. In severe cases, particularly in infants, the disease can lead to death. In adults, while the disease is less likely to be fatal, the prolonged coughing can lead to complications like rib fractures, weight loss, and severe fatigue.

Vaccination still remains the most effective way to prevent whooping cough. The primary vaccines used today are the DTaP and Tdap vaccines. The former is given to infants and young children, typically in a series of five doses to protect against diphtheria, tetanus, and whooping cough. The latter is a booster given to adolescents and adults to maintain immunity, with a particular emphasis on protecting pregnant women who can pass antibodies to their babies before birth. Both vaccines contain inactivated forms of the toxin produced by the bacteria that cause the three diseases. The Center for Disease Control and Prevention recommends that pregnant women receive the Tdap vaccine during each pregnancy, ideally between 27 and 36 weeks of gestation, to provide newborns with the highest level of protection against the disease. 

In New York City, the Department of Education requires the DTaP vaccine for all students and the Tdap vaccine for students after the sixth grade, leading to high student vaccination rates in most schools. However, vaccination doesn’t guarantee complete immunity, and whooping cough can still occur in cases where vaccination was unsuccessful or if immunity has waned. For those infected, whooping cough is generally treated with antibiotics, which are most effective when administered early. Once the infection progresses, antibiotics are unlikely to help, even though most people still have symptoms. The remaining symptoms occur due to damaged airways, which take time to heal.

Whooping cough, while largely preventable through vaccination, remains a significant public health concern, particularly for infants and individuals that are pregnant or have chronic respiratory illnesses. Its highly contagious nature and potential for severe complications underscore the importance of awareness, early diagnosis, and preventive measures like vaccination. The recent cases at Stuyvesant High School serve as a stark reminder of the ongoing need for vigilance against this disease. By staying informed and ensuring we have up-to-date vaccinations, we can protect ourselves and those most at risk, ensuring that the specter of whooping cough is kept at bay.