With another spike in cases of whooping cough, vaccination is key

IT is somewhat ironic that the word pronunciation is itself often mispronounced.

Although there is a degree of debate over the correct way to say it, there is at least a right and wrong answer — “pronounciation” is a misspelling and therefore incorrect.

However, there are a lot more words whose pronunciation is far more contentious with no definitive answer.

Tomato is one of the well-known ones, albeit with a bit of a transatlantic divide.

Within the medical world, things are no different. I say “para — see — tamol” whereas a lot of people say “para — seh — tamol”. We say “tin-nuh-tus” here in the UK, while the American pronunciation of tinnitus is “tin-night-tus”.

Whooping cough is another one that falls into this category. I’ve asked a few people over the past week or so how they pronounce “whooping” and there is by no means a consensus, although the most common pronunciation seems to be “hooping” cough.

“Wooping” is perfectly acceptable though. It is not as if it is named after a person or derived from a classical root word like so many others. Rather, whooping cough is onomatopoeic, modelled after the sound a sufferer makes in between coughs as they gasp for air.

If you were to watch a video of a child with whooping cough, you would immediately grasp what I mean — it is really quite unpleasant.

At present, there is something of a surge in whooping cough cases in the UK. While last year there were 858 reported cases in England, so far this year there have already been 553.

The illness is caused by a bacterium called bordatella pertussis, discovered in 1906 by Jules Bordet and Octave Genou at a time when cases of whooping cough exceeded 120,000 annually.

Back then it claimed many lives, in particular those of very young children, to whom the illness is particularly dangerous.

The bacterium affects the upper airways and starts off initially just as any mild cold illness might do — think runny nose, sore throat and feeling a bit under the weather.

Rather than settle, however, after about a week the characteristic “whooping” begins during coughing fits that can last for several minutes. This can continue on and off for more than three weeks before easing.

The cough can remain, although no longer as severe, for several weeks, giving rise to another moniker it has picked up over the years — the 100- day cough.

The main concern during a bout of whooping cough is the airway and the ability to get enough air on board, hence the reason why babies are more vulnerable to complications and the need for hospitalisation.

Secondary pneumonias can develop and, with all of the coughing, patients are less likely to get fluid on board, leading to dehydration. While less severe in older children and adults, it is still not pleasant and can lead to rib pains or even hernias from all the coughing.

Fortunately, we don’t see anywhere near as many cases these days and this is all down to vaccination.

Since the first vaccinations in the Fifties, the number of cases has dramatically reduced.

With that said, there have been epidemics, most notably from 1977 to 1979 and 1981 to 1983, linked to vaccine hesitancy following discredited concerns about the vaccine.

The whooping cough vaccine is now a staple of the vaccination programme and is given to babies as part of their eight-, 12- and 16-week vaccinations along with a pre-school booster at three years and four months.

While this has kept cases relatively low in children for many years, a peak in cases in 2012 highlighted the need for a further vaccination to be given to pregnant women so that babies would be born with a degree of immunity that could carry them to their first vaccination at eight weeks.

Since then, the whooping cough vaccine has been given to pregnant women routinely, ideally between 16 and 32 weeks.

Once you have whooping cough, it is pretty contagious and remains so from six days after the cold symptoms start to three weeks after the coughing starts.

Because it mimics so many other mild viral illnesses in many cases, many episodes probably remain unreported but if there is a suspicion of whooping cough there is a number of steps to take.

Firstly, taking an antibiotic (as bordatella pertussis is a bacterium, not a virus) sooner rather than later will reduce the time you are contagious, meaning you can reduce time off from school or work from three weeks to just 48 hours. This won’t speed up recovery but can prevent the spread to others.

Although the cough may continue after three weeks, the need for antibiotics disappears as you will no longer be contagious anyway.

Secondly, testing to confirm the diagnosis can be helpful.

This may take the form of either a throat swab to see whether the lab can grow the bacteria or later on in the illness a blood test to check for antibodies that have mustered to fight the disease.

Other than that, if there is any concern at all that a sufferer is struggling with their breathing, an urgent check with the doctor is needed. If more of a mild bout, rest, fluids and paracetamol and/or ibuprofen are the way forward.

Whooping cough has been around for a long time but compared to many other infectious diseases, it is thought to be relatively young.

The first reports that can credibly point towards whooping cough emerged from 16th century Persia followed shortly afterwards by an epidemic with remarkable similarities in Paris.

The term “100-day cough” is thought to have emerged from ancient Chinese medicine but here it gets a bit more vague as to whether pertussis was the culprit.

Either way, compared with the last 500 years at least, we are fortunate to live at a time when cases are relatively low and those we do know about we can treat effectively.

But, however you choose to pronounce it, it is on the rise once more, at a time when vaccination rates in pregnant women have fallen from 70 per cent in 2017 to 58 per cent last year.

Chances are it is no coincidence that we are seeing a spike in cases, so for such a nasty illness it really is important to ensure you take up the offer of the vaccine that we know has helped so much.