DRHOOK- Take a whooping: ‘100-day cough' making a return

the handsome doctor John Hong

Whooping in my day was as normal as apple pie. I'm not saying it was right or wrong. It just was. As adults, we still take whoopings– from life. 

"You're now responsible for seven extras duties on top of what you already have– without a bonus or pay increase. Mazel tov!" 

"Your HVAC works as well as a rusty fan. $10,000, please. Cheers!" 

"Your wife is cheating on you– with your sister. Party on!" 

What happens if you get whooping cough?

Whooping cough comes from a bacterial infection caused by Bordetella pertussis (sounds like an Italian fashion designer). Pertussis is highly contagious, so if someone coughs on or around you, you can catch it. If one person has it at home, 80 percent of household members will catch it, but it can take anywhere from one to ten days for symptoms to start after contracting the bug. 

In the 1920s and ‘30s, it was a feared childhood killer, as about 9,000 of 250,000 suffering kids died from whooping cough. Infants less than six months old are most at risk of dying.

Why the term, "whooping"? Whooping cough gives people uncontrollable coughing fits so they end up gasping for air and make a whooping sound.

Whooping cough is also known as the "100 Day Cough" because it can last from weeks to months. Kids are sicker than adults, but it's still awful for anyone. As with so many other illnesses, the symptoms usually mimic the common cold at first: stuffy-runny nose, sneezing, watery-red eyes, and of course that cough. A low-grade fever can be present for weeks to months. 

The cough– oh, the cough– starts to get worse and becomes a fit of rapid coughs— to a long gasp/whoop for air— and back to cough, cough, cough. This "paroxysmal phase" of coughing lasts one to six weeks but maybe as long as 10-12 weeks, in particular in adolescents and adults. Adults "whoop" less than kids, so in them it's easily misdiagnosed as just bronchitis. 

Of course, the coughing spells increase at night. The spells get worse over the first two weeks. Irritants like cigarette smoke (or nothing) can precipitate an attack. 

From the blasts of coughs, the face can turn red, and sweating often occurs. Vomiting after a coughing fit is not uncommon. If infants or children can't get enough oxygen, their feet and hands can turn blue! As whooping cough winds down, coughing spells decrease over two to three weeks. 

A vaccine was developed against pertussis in 1940, and it was combined with two other vaccines against diphtheria and tetanus (called DTaP). By 1976, whooping cough was virtually eliminated in the US. However, it has been rising since the 1980s, and California and Philadelphia saw outbreaks this year. 

Part of the reason for the increase in whooping cough is that adults who were vaccinated decades ago might not have immunity anymore. Adults who get whooping cough aren't as sick as kids, but can still pass on pertussis to kids very easily. That's why adults should be getting their DTaP vaccines. 

Treatment involves macrolide antibiotics like Z-pak or Biaxin. Labs aren't often done to diagnose pertussis because it can take one to two weeks to get results, and frankly, many labs aren't able to test for it. A CBC can show an increase in white blood cells, but a chest X-ray usually doesn't show much. 

If a cough is giving you a whooping, it would be wise to see your doctor before you give it to your family and co-workers. Also getting a DTaP booster shot can save you from another whooping. (I wonder if Whooping Goldberg should do a campaign ad on this subject?)


Dr. Hook cracks a joke or two, but he's a renowned physician with an interesting website, drjohnhong.com. Email him with your questions.