Whooping cough not extinguished

Dear Dr. Roach: My adult son has serious medical issues. Because of a persistent cough, he saw an internist, a pulmonologist, had blood tests and X-rays. Diagnoses included: a cold, allergies and sleep apnea. For months, he was prescribed different antibiotics and steroids, plus other medications.

Soon I, too, had symptoms. One night my cough changed in both sound and severity. My throat was sore and my glands swollen: I knew the diagnosis. The next day, I went to the doctor and said, “I have adult whooping cough.” He agreed and put me on doxycycline for four weeks. My son is finally on a similar medication.

How long is this contagious? When we are better, should we take a booster shot? How long are vaccinations and booster shots effective? — L.S., R.N.

Whooping cough is caused by the bacterium Bordatella pertussis and is a very contagious illness. In adults, it causes nonspecific symptoms, including a cough that can be severe.

The infection typically begins seven to 10 days after exposure. The first phase lasts one to two weeks and seems like a cold with a mild cough.

The second phase is characterized by severe cough that is forceful and can lead to vomiting, fainting or loss of urine. This phase can last three months.

The convalescent phase is a week or two, during which symptoms gradually decrease. People are most infectious in the first phase and the first two weeks of the second phase. This is the time when antibiotics also are most effective. Azithromycin is the usual treatment.

Neither natural infection nor vaccination leads to lifelong immunity. It’s important to know if there is an outbreak in the area; many public health departments send that information by email.

Adults should have a booster vaccine, the TDaP.

Write to Dr. Roach at ToYourGoodHealth @med.cornell.edu.