Can people over 70 get a whooping cough?

While commonly thought of as a childhood disease, the Centers for Disease Control and Prevention reports that a significant percentage of whooping cough cases occur in adults. This is a critical consideration for older adults, raising the important question: Can people over 70 get a whooping cough, and what are the risks involved?

Quick Summary

Adults over 70 can and do get whooping cough, also known as pertussis, as immunity from childhood vaccines fades over time. With a higher risk of severe complications like pneumonia and rib fractures, vaccination is crucial for this age group.

Key Points

• Seniors are vulnerable: People over 70 can easily contract whooping cough due to reduced immunity from childhood vaccinations.

• Atypical symptoms: In older adults, pertussis may present as a long-lasting, hacking cough without the classic 'whoop' sound, leading to misdiagnosis.

• Severe complications: Seniors face a higher risk of serious complications like pneumonia, rib fractures, and dehydration from severe coughing fits.

• Tdap vaccine is crucial: The Tdap vaccine provides essential protection against pertussis, and a booster is recommended for adults, especially those around infants.

• Early treatment is key: If whooping cough is suspected, consulting a doctor promptly is important, as antibiotics can reduce the spread of the disease if given early.

• Prevention is the best strategy: Staying up-to-date on vaccinations is the most effective way to protect older adults from the potentially dangerous effects of whooping cough.

Understanding Whooping Cough: It’s Not Just for Kids

Whooping cough, or pertussis, is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. While the characteristic “whooping” sound is most common in children and infants, older adults may not exhibit this classic symptom, leading to delayed diagnosis. The illness typically begins with mild, cold-like symptoms, which escalate into severe, uncontrollable coughing fits over one to two weeks. For seniors, whooping cough poses unique and serious health risks.

Why Seniors Are at a Higher Risk

Several factors contribute to the increased vulnerability of older adults to whooping cough:

• Waning Immunity: Immunity from childhood pertussis vaccinations or natural infection diminishes over time. Without a booster, seniors are susceptible to contracting the disease.
• Immunocompromised State: The immune system weakens with age, making it more challenging for the body to fight off infections. Chronic illnesses common in older adults, such as COPD or heart disease, can further weaken the immune system.
• Atypical Symptoms: Pertussis in older adults often presents as a persistent, dry cough rather than the distinct whooping sound, making it easier to misdiagnose or dismiss as a different ailment.
• Increased Exposure: Many adults unknowingly transmit pertussis to vulnerable infants and other family members. Staying up-to-date on vaccinations protects not only the senior but also those around them.

The Dangerous Complications of Pertussis in Seniors

While whooping cough can be a mild inconvenience for some adults, it can lead to severe and potentially life-threatening complications for people over 70. These complications are often the result of violent, prolonged coughing fits.

List of Potential Complications:

• Pneumonia: A lung infection that can be especially dangerous for older adults.
• Rib Fractures: The force of severe coughing can lead to bruised or broken ribs.
• Weight Loss and Dehydration: Coughing fits can make it difficult to eat and drink, resulting in unintentional weight loss and dehydration.
• Loss of Bladder Control: The strain from coughing can cause urinary incontinence.
• Loss of Consciousness: Severe coughing can lead to fainting or passing out.
• Sleep Deprivation: Persistent coughing, often worse at night, can lead to severe exhaustion.

The Role of Vaccination in Prevention

Vaccination is the most effective defense against pertussis. The Centers for Disease Control and Prevention (CDC) recommends that all adults receive a single dose of the Tdap vaccine, which protects against tetanus, diphtheria, and pertussis.

Vaccination Recommendations:

1. Initial Tdap Dose: Any adult who has never received a Tdap vaccine should get one dose.
2. Booster Shots: The CDC recommends a Td (tetanus and diphtheria) or Tdap booster every 10 years.
3. Special Considerations: Adults over 65 who will be in contact with infants should especially consider getting a Tdap booster.

Tdap vs. Tdap/Td Vaccination Plan for Older Adults

Feature	Tdap (Tetanus, Diphtheria, Pertussis)	Td (Tetanus, Diphtheria)
Provides Protection Against	Tetanus, Diphtheria, Whooping Cough	Tetanus, Diphtheria
Recommended First Dose?	Yes, for any adult who has not received a Tdap	No, Tdap should be given first
Recommended Booster?	Yes, every 10 years. Tdap is encouraged over Td during pertussis outbreaks or contact with infants.	Yes, an alternative to Tdap for the 10-year booster if pertussis protection is not the primary goal.
Recommended for Over 65?	Yes, Boostrix® is approved for ages 65+. Adacel® is approved for ages 64 and under, but providers can use Adacel® if Boostrix® is unavailable.	Yes, as a 10-year booster. However, Tdap is preferred to ensure continued pertussis protection.

What to Do If You Suspect Whooping Cough

If an older adult develops a persistent, hacking cough that lasts for more than a week, especially after a period of cold-like symptoms, it is crucial to consult a healthcare provider. Early diagnosis is key, as antibiotics are most effective at reducing the illness's severity and contagiousness if started early. While antibiotics may not shorten the duration of the cough itself if started later, they can still prevent the spread of the disease.

Supportive care is vital for managing symptoms, including staying hydrated, resting, and avoiding environmental irritants that can trigger coughing fits.

For more information on adult immunizations, visit the National Council on Aging at https://www.ncoa.org/article/tdap-vaccine-what-older-adults-need-to-know/.

Conclusion

Whooping cough poses a very real and serious threat to adults over 70, with the potential for severe complications due to waning immunity and weakened immune systems. The good news is that the risk can be significantly reduced through vaccination. Getting the Tdap booster and remaining vigilant about symptoms is essential for protecting the health and well-being of older adults.

Frequently Asked Questions

Why can people over 70 get a whooping cough even if they were vaccinated as children?

Immunity from the pertussis vaccine, as well as from having the disease, wears off over time. For older adults, this waning immunity leaves them vulnerable to infection, which is why booster shots are necessary.

What does whooping cough sound like in people over 70?

In seniors, the infection often presents as a persistent, severe, hacking cough rather than the high-pitched 'whoop' associated with the disease in children. This difference in presentation can make diagnosis challenging.

Is the whooping cough vaccine different for adults over 70?

Yes, while the DTaP vaccine is for young children, older children and adults receive the Tdap vaccine. For adults 65 and older, a specific Tdap formulation called Boostrix is preferred, though Adacel can be used if necessary.

What are the most common complications of whooping cough in older adults?

The most common complications for seniors include pneumonia, bruised or fractured ribs from severe coughing, urinary incontinence, fainting, and significant weight loss due to difficulty eating and drinking.

Can older adults spread whooping cough to infants?

Yes, adults who are unaware they have whooping cough are a significant source of infection for infants and young children, who are at the highest risk for severe and fatal complications. Vaccination of older adults is crucial to create a protective barrier.

What is the treatment for whooping cough in older adults?

Treatment involves antibiotics, which can help prevent the spread of the disease, especially if started early. Supportive care, including rest, fluids, and managing symptoms, is also very important. Over-the-counter cough medicines are not effective against pertussis.

How often should an adult over 70 get a whooping cough booster shot?

The CDC recommends that adults get a Tdap or Td booster shot every 10 years to maintain protection against tetanus, diphtheria, and pertussis. Older adults who are around babies should ensure their Tdap is up-to-date.