cough in a sick individual. Intervention, or treatment, can alsobe a problem because the toxins that B. pertussis produces donot respond to antibiotics or other medicines. Yet, early diag-nosis and treatment are critical if epidemics of whoopingcough are to be prevented and infant lives saved.

The Danger of Late DiagnosisWhen six-week-old Tristen Oliver of Merced, California, devel-oped the first symptoms of whooping cough in July 2010, hedid not seem very sick. He was coughing, but the cough wasnot severe, and he did not whoop. His mother took him to thepediatrician, who diagnosed him with an upper respiratory in-fection. The doctor sent the baby home and told the mother totake the baby to the emergency room if he got worse. He didget worse. He began coughing so hard that he turned red withthe effort; he vomited and refused to eat. Tristen’s mother tookhim to the hospital emergency room. She had heard about Cal-ifornia’s whooping cough epidemic and says, “I told the doctor

In California flyers in several languages urge people to be vaccinatedagainst whooping cough. In 2010 the state’s health officials declared apertussis epidemic.

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I was worried about whooping cough, but the doctor said itwasn’t that.”21 The baby still was not whooping, but the doctorgave him antibiotics anyway and sent him home. Still, Tristendid not improve, and two days later, his mother took him to adifferent hospital. There, she was told Tristen did not havewhooping cough and should stop taking the antibiotics. Thedoctor took an X-ray to be sure the infant did not have pneu-monia, said the baby was fine, and sent mother and baby home.But Tristen’s mother knew something was seriously wrong

with her baby. Again, after watching the baby cough so se-verely that he turned blue from lack of oxygen, she returnedwith him to the first hospital, which now admitted him andthen airlifted him to another hospital where he could receivespecialized care. There, Tristen was finally tested for and diag-nosed with whooping cough. Doctors sedated him, put him ona ventilator to help him breathe, and began the long fight tosave his life. Tristen’s mother says, “The hospital said he wouldbe there about a month. They said he’s pretty bad, but they’veseen worse.” She now believes that all parents should be awareof whooping cough and fight for an accurate diagnosis. Shewarns other parents, “Demand a test. Get them on antibiotics.If they are really bad, demand that they be admitted to the hos-pital. This has been a terrifying experience.”22

Doctors Need to “Think Pertussis”An accurate diagnosis of whooping cough, explains pertussis ex-pert and university professor James D. Cherry, can be a problem.He says, “It’s a tough diagnosis because the babies, they don’tlook very sick. They don’t have a fever. And they have a runnynose and a little cough.”23 These symptoms are the same as foran upper respiratory infection, such as a cold or other virus. Suchinfections are common in infants; they are not serious and donot require any special treatment. They are also much more com-mon than whooping cough, so they are the first diagnosis thatdoctors think of when they see a mildly sick infant. Nonetheless,Cherry and other whooping cough experts warn that in any areawhere an outbreak occurs, doctors should act rapidly to test forand treat whooping cough, especially in young children.

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