Opportunistic etiological agents causing lung infections: emerging need to transform lung-targeted delivery

Whooping Cough Kills Two Babies As Cases Soar

Whooping Cough Kills Two Babies as Cases Soar

The bacterial infection pertussis has sparked an uptick in cases nationwide and has caused two deaths in Louisiana

By Tanya Lewis edited by Dean Visser

Lorena Garibo/Getty Images

Two infants have died of whooping cough in Louisiana in the past six months, according to the surgeon general of the state's health department. The deaths from this vaccine-preventable illness are the first to occur in Louisiana since 2018.

There have been 110 cases of whooping cough in the state so far this year, compared with 154 cases in all of last year, CNN reported. Cases have been rising throughout the U.S. After they dropped dramatically during the COVID pandemic. There were 35,000 cases in the country last year—higher than any year since 2012.

The spike may have been driven by declining vaccination rates for childhood diseases. Two months ago Louisiana's health department said it would no longer promote vaccination. Similar declines may be behind the growing measles outbreak in Texas and neighboring states.

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What is whooping cough?

Whooping cough, or pertussis, is a type of respiratory infection caused by the bacterium Bordetella pertussis. It is extremely contagious, and symptoms can last for months. The bacteria attach to tiny, hairlike structures in the lungs called cilia, which help sweep the lungs clear of mucus and irritants. There the bacteria secrete toxins that damage the cilia and cause the airways to swell.

3D illustration of a group of aerobic, gram-negative, Bordetella pertussis bacteria.

imageBROKER/Stocktrek Images/Getty Images

What are the symptoms?

Early symptoms of whooping cough can resemble those of a common cold. A week or two later, many people start having violent coughing fits that usually last one to six weeks but can linger up to 10 weeks. People with the illness often produce a characteristic "whooping" noise as they gasp for air between coughs. The coughing can sometimes be so violent that it causes people to vomit or fracture a rib, according to the Centers for Disease Control and Prevention.

The disease can be especially dangerous to babies and young children, who may not cough at all but may struggle to breathe. About one in three babies with whooping cough are hospitalized. Those younger than a year old can develop apnea (potentially deadly pauses in breathing), pneumonia, convulsions and encephalopathy (brain disease). One in 100 babies hospitalized with whooping cough will die from complications of the illness.

Can the disease be prevented or treated?

Vaccines are effective at preventing serious cases of whooping cough, though they may not entirely prevent people from getting the disease. In the U.S. There are currently two pertussis vaccines in use, both of which also protect against diphtheria and tetanus: the DTaP vaccine is given to infants older than two months and young children, and the Tdap vaccine is used for older children and adults, including pregnant people.

The CDC recommends that children get vaccinated at two months, four months, six months, 15 through 18 months and four through six years of age. Adults should get vaccinated against diphtheria and tetanus at least every 10 years, and this includes protection against pertussis if the DTaP or Tdap vaccine is given. Though there's no official recommendation to get revaccinated for whooping cough specifically, some evidence suggests pertussis immunity only lasts about six years. Pregnant people should get the Tdap vaccine in their third trimester to provide protection to their baby prior to birth.

Whooping cough can be treated with antibiotics, but they are most effective if they are given early, before coughing fits have begun. After three weeks of infection, the drugs are unlikely to help because the body has cleared the bacteria, and the lingering cough is caused by airway damage. Cough medicines aren't usually effective either.

Most infections can be treated at home, but some may require hospitalization. Treatment consists of keeping airways clear and administering oxygen or fluids if needed.

This Rare Bacterial Infection Triggers Pus-filled Sores In The Lungs And Brain

Disease name: Nocardiosis

Affected populations: Nocardiosis is a rare but potentially deadly infectious disease caused by bacteria in the genus Nocardia. Nocardiosis is an opportunistic infection, meaning it doesn't typically affect healthy people but may seize the chance to infect people with weakened immune systems, such as people with cancer or HIV/AIDS, as well as organ transplant recipients who are taking immunosuppressive drugs.

However, around 20% to 30% of patients with nocardiosis have no known pre-existing conditions, so the infection doesn't exclusively affect people with immune deficits. People over the age of 40, especially men, are also more likely to develop the disease than other demographics.

Between 500 and 1,000 new cases of nocardiosis are reported in the United States every year.

Related: Scientists have found a secret 'switch' that lets bacteria resist antibiotics — and it's been evading lab tests for decades

Causes: Nocardia bacteria are found in soil, standing water and decaying plant material. Around 100 Nocardia species have been identified so far, of which 12 are known to infect humans.

People may become infected with Nocardia bacteria when they inhale dust containing the microbes or they have a cut or scrape that comes in contact with contaminated soil or water.

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Nocardiosis is not known to spread from one person to another; people pick it up directly from the environment.

Symptoms: The symptoms of nocardiosis vary depending on which part of the body is infected by Nocardia bacteria.

Most cases of nocardiosis start out as lung infections, in which pus-filled cavities, or abscesses containing the bacteria, form in the lungs. This can cause symptoms such as chest pain, a cough (including coughing up blood), sweats, chills and general weakness.

Image 1 of 2

(Image credit: CDC/ Dr. Libero Ajello via CDC PHIL)

Skin ulcers on the arm of a patient infected with nocardiosis.

Nocardia bacteria can then travel in the bloodstream and form abscesses in other regions of the body, including the brain, kidneys and intestines. Infections of the brain can cause headache, weakness, confusion and seizures.

Approximately one-third of all patients infected with nocardiosis develop skin ulcers or sores, instead of an internal infection. These skin lesions typically form across the hands, chest wall or buttocks. They may look like open wounds or bumps under the skin.

Without treatment, nocardiosis can rapidly lead to death, often by causing organ failure or sepsis, a dangerous body-wide immune reaction. Between 16% and 40% of patients with nocardiosis die as a result of their infection. If the disease spreads to the brain, death rates jump to more than 80%.

Treatments: Nocardiosis can be treated with common antibiotics, although these bacteria are normally resistant to penicillin. The antibiotic treatment usually takes between six and 12 months to complete, and some patients may need to take antibiotics for even longer to prevent the disease from coming back.

Surgery may sometimes also be required to remove specific abscesses from the body, especially if a patient is not responding to antibiotic treatment.

Disclaimer

This article is for informational purposes only and is not meant to offer medical advice.

Could Your Cold-Like Symptoms Be Whooping Cough? How To Identify The Latter

When you have a runny nose or a mild cough, you're likely to suspect a common cold. However, these cold-like symptoms are not just limited to a viral infection; they can also indicate a more serious condition called whooping cough, a highly contagious bacterial infection characterised by severe coughing episodes. Dr Manoj AG, Consultant Physician at Practo, Bengaluru, sheds light on the distinguishing factors and shares ways to prevent the condition.

Also Read: Whooping Cough Deaths Hit Record High in US—What Makes This Infection So Dangerous?

What Is Whooping Cough?

Whooping cough, also known as pertussis, is a very contagious respiratory infection caused by the bacterium Bordetella pertussis. It is characterised by severe coughing fits and ends with a 'whooping' sound as the air is inhaled.

According to the World Health Organization (WHO), there were more than 1.51 lakh cases of whooping cough globally in 2018. The health body explains that it spreads easily from person to person, primarily through droplets from coughing or sneezing. It is most dangerous for infants and is a leading cause of disease and death in this age group.

How To Differentiate Between Cold And Whooping Cough

Dr Manoj says, "The primary differences between a common cold and whooping cough (pertussis) lie in their symptom progression and intensity." He explains that a common cold typically causes mild symptoms like a runny nose, sore throat, occasional low-grade fever, and a manageable cough that resolves within a week.

Whooping cough, on the other hand, begins with similar cold-like symptoms but escalates into prolonged, severe coughing fits, the doctor distinguishes. "These fits may be followed by a distinctive 'whooping' sound as the person gasps for air—though this hallmark symptom is less common in infants, older adults, or immunocompromised individuals."

Stages Of Whooping Cough

The three main stages of whooping cough are:

Catarrhal phase (1–2 weeks): Mimics a cold with sneezing and mild cough.

Paroxysmal phase (1–6 weeks): Intense coughing spells, often worse at night, which may cause vomiting or breathlessness.

Convalescent phase (weeks to months): Gradual recovery, though coughing can linger.

When To Seek Medical Attention

Here's who and when one should seek medical attention for whooping cough:

Infants under 6 months, pregnant individuals, and those with weakened immune system face the highest risk of severe complications, such as pneumonia, rib fractures, or seizures. Rarely, it can be fatal in young babies.

A cough that lasts over two weeks.

Coughing fits that lead to vomiting, difficulty breathing, or cyanosis (bluish skin).

Infants exhibit pauses in breathing (apnoea) or exhaustion after coughing.

Prevention Strategies

Whooping cough can be concerning, and therefore, it is crucial to learn about the strategies to prevent it. Here's what you can do:

Vaccination:

DTaP vaccine: Protects children (doses at two, four, six, and 15–18 months; booster at four to six years).

Tdap booster: Recommended for adolescents (ages 11–12) and adults every 10 years. Pregnant individuals should receive Tdap during the third trimester of each pregnancy to protect newborns.

Hygiene and Isolation:

Practise frequent handwashing, cover coughs/sneezes, and disinfect surfaces.

Isolate infected individuals until five days after starting antibiotics (or three weeks without treatment).

Protect High-Risk Groups:

Ensure caregivers and close contacts of infants are vaccinated ("cocooning strategy").

Exposed individuals may require prophylactic antibiotics to prevent spread.

Early diagnosis and treatment of whooping cough are critical to curb transmission and reduce risks.

Conclusion

Initially, a whooping cough can mimic symptoms of a cold. However, over time, it can lead to more severe coughing fits, which can be a distinguishing factor. It is crucial to get yourself tested and assessed by a doctor or medical professional. Only once you have the confirmed diagnosis can you be treated properly.

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