Symptoms and Diagnosis
You'd think that with all the hacking, yakking, and fainting going on that pertussis would be easily recognized, but both parents and physicians commonly overlook it. "Because so many illnesses have the same complaints as pertussis, it is often times not diagnosed until it's severe," explains Dr. Patton. "The first symptoms of whooping cough mimic a common cold: a brief low-grade fever, runny nose, and a mild cough. Over the course of one to two weeks, that irritating little cough gradually morphs into a wet hack that brings up thick mucus, leading sufferers, mothers, and some doctors to suspect that it's simply a bad cold with a helpful productive cough." But the coughing spells get longer and stronger, some lasting for over a minute, until the child turns red or blue and struggles for air in between coughs. The sharp, rapid intake of breath in between coughs is what creates the telltale whooping sound.
But here's the catch—some kids whoop, and some don't. What's more, children can look and feel perfectly healthy in between coughing episodes. After the initial fever, my munchkins maintained strong appetites, slept well at night, and ran around all day long. Except for coughing myself to tears a few times a day, I felt fine, too. That's why entire families can have the disease and never know it. Doctors miss it all the time. Many cases go undiagnosed because the physician never hears the patient cough and the kids appear fine at the office.
"A common misperception, even among doctors, is that if a child is immunized, they can't get pertussis," says Dr. Patton. "The truth is that a child who isn't immunized can die from it, but an immunized child can get very sick and have a bad cough." Thanks to the CDC's new immunization booster recommendations and recent media attention about whooping cough, physicians are now realizing how common the illness really is.
If you suspect you or your children have contracted the disease and your concerns aren't being properly addressed, wait in the doctor's office as long as you need to for a coughing spell to occur or videotape an episode at home (first thing in the morning and bedtime are good times to catch one) and replay the scene for your pediatrician later. For a definitive pertussis diagnosis, doctors can take a culture of respiratory fluids or perform a blood test.