What to know about whooping cough in adults

Last reviewed Fri 22 February 2019

By Jamie Eske

Reviewed by Vincent J. Tavella, MPH

1. Symptoms
 
2. Diagnosis
 
3. Complications
 
4. Treatment
5. Risk factors
 
6. Prevention
 
7. Takeaway

Whooping cough, or pertussis, is a highly contagious condition. This infection is most common in infants, but people of all ages can contract it.

Whooping cough symptoms tend to be less severe in adults than in children. Unvaccinated infants have the highest risk of developing severe symptoms and complications from whooping cough.

In this article, we discuss the symptoms and complications of whooping cough in adults and the treatment options.

Symptoms in adults

Whooping cough can affect adults and it is often less severe than in children.

Adults tend to experience less severe symptoms of whooping cough compared with children. The reason for this is that adults have built up immunity from previous infections and vaccinations.

Bacteria called Bordetella pertussiscause whooping cough. These bacteria spread through the air when someone who is infected coughs or sneezes. Symptoms usually develop 5 to 10 days after exposure, but some people might not develop symptoms for several weeks.

Whooping cough develops in three stages:

Stage 1: People are highly contagious in the early stages of the disease. At first, whooping cough causes mild cold-like symptoms that last for 1 to 2 weeks, such as:

• a runny nose
• sneezing
• a low-grade fever
• fatigue
• a mild cough
• watery eyes

Stage 2: After some time, people can develop a severe, persistent cough that leaves them gasping for air. The classic "whooping" sound occurs when people inhale sharply to catch their breath after a coughing fit.

People are still contagious at this point, and stage 2 symptoms may last anywhere from 1 to 6 weeks.

Stage 3: In the final phase, the cough gradually improves, and coughing fits occur less often. At this point, people are no longer contagious, but they run the risk of developing other infections, which can slow down the recovery process.

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Diagnosis

A doctor can diagnose whooping cough by looking at a person's medical history and current symptoms.

Doctors might sometimes misdiagnose whooping cough as a common cold or another respiratory infection because whooping cough in adults does not typically cause severe symptoms.

If an adult is experiencing a persistent cough, the doctor may recommend further medical tests to diagnose the problem. These tests might include a nasopharyngeal swab, which involves a doctor collecting a sample of mucus through the nose to analyze for B. pertussis bacteria.

Complications

Whooping cough can make it difficult to sleep.

Adults can develop secondary complications from whooping cough. Violent coughing fits can cause fainting or fractured ribs.

Other potential complications of whooping cough in adults include:

• difficulty falling asleep or staying asleep, called insomnia
• difficulty breathing while sleeping, called sleep apnea
• unintentional weight loss
• pneumonia
• eye infections

Treatment

Treatment depends on the duration of the illness and the severity of its symptoms. Whooping cough treatment usually involves antibiotictherapy.

Early antibiotic treatment may reduce symptom severity, speed up recovery time, and prevent people from transmitting the bacteria. A healthcare professional might prescribe antibiotics for other members of the household as well.

According to the Centers for Disease Control and Prevention (CDC), antibacterial treatments are most effective during the first 2–3 weeks of infection or before coughing fits begin. However, people rarely receive treatment early enough to experience these benefits.

Home remedies for whooping cough include:

• staying hydrated
• resting
• using a mist vaporizer
• practicing proper hand hygiene
• eating frequent small meals rather than three large meals to avoid vomiting
• avoiding coughing triggers, such as smoke, strong chemicals, and allergens

Whooping cough does not respond to traditional cough medication. The American Lung Association advise against treating whooping cough with cough medications.

Recovering from whooping cough can take several weeks, and a cough can continue to linger for many months.

Risk factors

Whooping cough is highly contagious, and whooping cough vaccinations wear off as people get older.

Adults who have not received the whooping cough booster vaccine Tdap (tetanus-diphtheria-acellular pertussis) have a higher risk of contracting whooping cough.

Other factors that increase a person's risk of getting whooping cough include:

• being in close contact with someone who has whooping cough
• having a weakened immune system
• being pregnant

Prevention

Whooping cough vaccines are available for both children and adults.

Adults can protect themselves and their children from whooping cough by having vaccines against the disease.

There are two types of whooping cough vaccine:

• DTaP for infants and young children
• Tdap for adolescents and adults

Both vaccines protect against tetanus, diphtheria, and whooping cough.

The Department of Health and Human Services recommend that infants and children receive doses of the DTaP vaccine at the following ages:

• 2 months
• 4 months
• 6 months
• 15–18 months
• 4–6 years

The initial round of DTaP vaccines wears off over time, so people should get the Tdap booster vaccination to maintain immunity.

The CDC recommend the following Tdap vaccination schedule for everyone:

• One booster vaccine between the ages of 11 and 12 years.
• One dose of Tdap for adults who have never received the vaccine.
• One Tdap vaccine during the third trimester of every pregnancy.

In general, these vaccines are safe for most people. However, whooping cough vaccines can cause temporary side effects in some people, such as:

• soreness or swelling near the injection site
• fatigue
• nausea
• diarrhea
• vomiting
• loss of appetite
• fever
• a headache
• body aches

Takeaway

Whooping cough, or pertussis, is a highly contagious bacterial infection that affects the respiratory tract.

Although whooping cough usually produces milder symptoms in adults, it can cause severe illness in infants and young children.

There are two forms of vaccine that protect against whooping cough. The DTaP vaccine protects infants and young children, but it wears off over time. Adolescents and adults can get a booster vaccine called Tdap.

Sleep apnea: Daytime sleepiness might help predict cardiovascular risk

Published Saturday 23 February 2019

By Chiara Townley

Fact checked by Jasmin Collier

A recent study categorizing people with obstructive sleep apnea based on their differing symptoms found a strong link between excessive daytime sleepiness and cardiovascular disease.

OSA increases hypertension risk.

Obstructive sleep apnea (OSA) causes sporadic airflow blockages during sleep.

All of the different types of sleep apnea, OSA is the most common.

Symptoms include snoring, daytime sleepiness, difficulty concentrating, and high blood pressure.

OSA occurs when the throat muscles relax too much to keep the airway open.

According to the National Sleep Foundation, more than 18 million adults in the United States have sleep apnea. If a person does not seek treatment, it can lead to several complications — one of which is cardiovascular disease.

Sleep apnea and cardiovascular problems

According to the American Thoracic Society, about 30 percent of people with high blood pressure, or hypertension, have OSA. Also, individuals with OSA have a 50 percent chance of developing hypertension.

However, researchers do not yet know why people with OSA are likelier to develop heart disease.

When these breathing pauses occur, the oxygen level in the blood gets low, and these frequent bouts of low oxygen levels during sleep may damage the blood vessels that supply the heart.

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During these pauses, the heart beats faster and the blood pressure goes up. Severe OSA can also cause the heart to become enlarged. When this occurs, the heart receives less oxygen and works less efficiently.

Previous studies have identified a link between OSA and heart disease. However, to understand the association better, researchers categorized people with OSA based on their symptoms and conducted a new study.

Their results now appear in the American Journal of Respiratory and Critical Care Medicine.

Excessive sleepiness: A marker of risk?

The researchers categorized the participants into four subtypes of OSA according to the symptoms they reported, which included: difficulty falling and staying asleep, snoring, fatigue, drowsy driving, disturbed sleep, moderate sleepiness, and excessive sleepiness. The four subtypes were:

• those with disturbed sleep
• those with few symptoms
• those who felt moderately sleepy
• those who felt excessively sleepy

The study analyzed data from more than 1,000 adults who had moderate to severe OSA (which the scientists defined as having at least 15 breathing pauses while sleeping or reduced breathing).

All had participated in the Sleep Heart Health Study, which was availablefrom the National Sleep Research Resource. The team followed the participants for about 12 years.

"Multiple studies from our group," explains study co-author Dr. Diego Mazzotti, at the University of Pennsylvania in Philadelphia, "have shown that patients with moderate to severe OSA throughout the world can be categorized into specific subtypes based on their reported symptoms."

"However," he notes, "until now, it was unclear whether these subtypes had different clinical consequences, especially in regard to future cardiovascular risk."

A 'surrogate marker'

The analysis showed that participants with OSA who experienced excessive sleepiness had higher rates of cardiovascular disease at enrollment when compared with people without OSA.

Also, they were around twice as likely to experience cardiovascular issues during the follow-up period.

The researchers are aware that these results do not prove that excessive sleepiness is a causal factor for cardiovascular disease. That said, they do believe that this specific symptom of OSA could be a "surrogate marker of underlying cardiovascular risk pathways."

Despite the study's limitations, the team suggests that treatments for OSA, such as continuous positive airway pressure (CPAP), should focus on people who have the excessive sleepiness subtype, as they would benefit the most.

CPAP uses machines that keep airways open to allow people to breathe properly during sleep.

"Even without further research, clinicians should recognize that patients with OSA who complain of feeling tired when they wake up and sleepy during the day and have a high score on the Epworth Sleepiness Scale are at greater risk for cardiovascular disease."

This Japanese plant could hold the key to extended youth

Published Thursday 21 February 2019

By Maria Cohut

Fact checked by Gianna D'Emilio

In Japan, many have long believed that a plant called ashitaba is important in supporting a person's health and well-being. Now, researchers are suggesting that a compound in this plant boosts cellular health and may prolong youth.

Practitioners of traditional medicine in Japan have long touted ashitaba's health benefits. New research suggests that they may be right.

Part of the way in which the body maintains health at a cellular level is through the process of autophagy. 

This involves cells disposing of their own broken and disused parts to prevent the buildup of debris.

If autophagy is not efficient, the cellular debris that accumulates can become harmful, exposing healthy cells to stress and contributing to the development of a range of diseases and conditions, including cancer.

Previous research has shown that there are a few ways to induce or boost autophagy, including intermittent fasting and exercise.

There are also certain compounds that may help enhance this self-renewing cellular process. In a new study, researchers from the University of Graz in Austria have turned to a specific class of compounds called flavonoids.

These are naturally occurring substances found in many common plants, with a proven antioxidant effect that, researchers believe, shields cellular health and may help protect the body against numerous diseases.

Autophagy, explains study author Professor Frank Madeo, Ph.D., "is a cleansing and recycling process" that disposes of "superfluous material, especially cellular garbage like aggregated proteins."

Prof. Madeo and the team thought that there could be a connection between this cellular process and the action of flavonoids. In their new study — the findings of which appear in the journal Nature Communications — they analyzed 180 such compounds in search of the one best-equipped to "counteract age-related cell demise."

A plant substance with protective effects

The researchers eventually stopped at a compound known as 4,4'-dimethoxychalcone (DMC). This flavonoid is highly present in Angelica keiskei, or ashitaba, a plant from the carrot family that is native to Japan.

Japanese tradition holds the ashitaba plant in great regard, and to this day it is a key ingredient in Japanese botanical medicine.

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Thanks to the current study's findings, evidence regarding ashitaba's benefits is accumulating exponentially. "It is always nice to find a scientific rationale for traditional medical folk tales," Prof. Madeo notes.

After identifying DMC as a potential autophagy-booster, the researchers' first step was to conduct experiments in yeast cells. These soon revealed that the substance did protect these cells from age-related damage, and it did so more efficiently than other compounds known to bring similar benefits, such as resveratrol, a phenol found in grape skin.

Further experiments on fruit fly and worm cells yielded the same results. "Remarkably, chronic DMC treatment [...] prolonged the median lifespan of both model organisms by approximately 20 percent," the investigators write.

The team did not stop here, however. It also tested the effect of DMC on mouse heart cells, findings that the substance once more boosted autophagy. DMC also appeared to protect against liver damage caused by ethanol (pure alcohol).

Finally, Prof. Madeo and colleagues tested the compound's effect on different types of human cells, confirming the same positive outcome, although the researchers warn that real certainty can only come from future clinical trials.

"The experiments indicate that the effects of DMC might be transferable to humans, although we have to be cautious and wait for real clinical trials."

Prof. Frank Madeo, Ph.D.

The next step from here, the researchers say, will be to conduct a more detailed study in mice, assessing whether DMC's protective effect on heart cells means that the substance will also shield the rodents from age-related diseases.

Blueberries may lower cardiovascular risk by up to 20 percent

Published Saturday 23 February 2019

By Ana Sandoiu

Fact checked by Gianna D'Emilio

The phytochemicals that give blueberries their blue color can significantly improve cardiovascular health, finds a new two-part study.

The positive effect that blueberries can have on blood pressure is comparable to that of hypertension drugs.

Dubbed "the silent killer" because it has no visible symptoms in its early stages, hypertension affects approximately 1 in 3 adults in the United States.

The condition puts a strain on the cardiovascular system, which in the long run may contribute to heart failure, stroke, and kidney failure.

The National Institutes of Health (NIH) recommend that people with high blood pressure stay in control of the condition by eating healthfully, exercising, not smoking, and maintaining a healthy weight.

But should you eat anything in particular to keep your arteries healthy? In a previous Spotlight feature, we rounded up 16 foods that studies have suggested can improve cardiovascular health.

Along with broccoli, spinach, pulses, and fish, berries may also reduce heart disease, due to their antioxidant polyphenols.

New research zooms in on the cardiovascular effects of blueberries and finds that anthocyanins — the phytochemicals that give blueberries their color — mediate the beneficial effects that this fruit has on the cardiovascular system.

The lead author of the study is Ana Rodriguez-Mateos, Ph.D., from the Department of Nutritional Sciences at King's College London, in the United Kingdom. The researchers published their findings in The Journals of Gerontology: Series A.

Anthocyanins and blood pressure

Rodriguez-Mateos and her colleagues recruited 40 study participants who were in perfect health and randomly divided them into two groups: One received a daily drink consisting of 200 grams (g) of blueberries, and another group received a control drink.

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To examine the effects of the blueberries, the researchers took the participants' blood pressure and measured the flow-mediated dilation (FMD) of their brachial arteries.

FMD is a standard indicator of cardiovascular risk; it measures how much the brachial artery widens when blood flows at a higher rate.

In the second part of the study, the researchers compared drinking blueberries with drinking purified anthocyanins or control drinks that had concentrations of fiber, minerals, or vitamins equivalent to those in blueberries.

Blood pressure decreases by 5 mm Hg

The scientists noticed the beneficial effects of the blueberry drinks only 2 hours after the participants had consumed them.

"Purified anthocyanins exerted a dose-dependent improvement ofendothelial function in healthy humans, as measured by [FMD]," report the authors.

The endothelium is a type of membrane inside the heart and blood vessels. It contains endothelial cells that help control the dilation and contraction of the arteries.

Endothelial cells also help keep blood pressure in check and play a key role in blood clotting.

The authors continue, "[t]he effects were similar to those of blueberries containing similar amounts of anthocyanins, while control drinks containing fiber, minerals, or vitamins had no significant effect."

After a month of having 200 g of blueberries each day, the participants' blood pressure decreased by 5 millimeters of mercury (mm Hg), on average. The researchers note that such a decrease is usually obtained with medication.

"Our results identify anthocyanin metabolites as major mediators of vascular bioactivities of blueberries and changes of cellular gene programs," conclude the researchers.

Rodriguez-Mateos comments on the findings, saying, "although it is best to eat the whole blueberry to get the full benefit, our study finds that the majority of the effects can be explained by anthocyanins."

The scientists explain that anthocyanins "circulate in [the] blood as phenolic acid metabolites."

"If the changes we saw in blood vessel function after eating blueberries every day could be sustained for a person's whole life, it could reduce their risk of developing cardiovascular disease by up to 20 [percent]."

What diet is best for older adults?

Published Today

By Monica Beyer

Fact checked by Carolyn Robertson

A new study has revealed that a diet rich in protein and low in calories can help older adults with obesity lose more weight while maintaining muscle mass and improving bone density.

Losing weight as an older adult presents some challenges.

Older adults often lose bone density and muscle mass when they concentrate on shedding weight.

This unwanted bone and muscle loss can result in mobility issues and can even increase a person's risk of injury.

A recent study, which Wake Forest University in Winston-Salem, NC, is the lead on, has shown that a high-protein, low-calorie diet can help adults avoid these problems.

Several peer-reviewed journals, which include Journals of Gerontology: Medical Sciences and American Journal of Clinical Nutrition have accepted four research papers from the study for publication.

The researchers randomly selected 96 adults over 65 years of age and assigned them to one of two groups.

They put the first group on a 6-month, low-calorie meal plan that was also high in protein — more than 1 gram (g) of protein per kilogram (kg) of body weight. They assigned the other group to a weight-maintenance plan that included 0.8 g of protein per kg of body weight.

High-protein, low-calorie

Those in the high-protein, low-calorie diet group experienced the most weight loss, but more revealing was that those in this group maintained their muscle mass. They also lost weight on the stomach, hips, thighs, and rear, which can decrease the risk of certain medical conditions, including diabetes and stroke.

Furthermore, the researchers found that the participants in the high-protein group improved their bone quality, and they gained 0.75 points on their Health Aging Index scores, involving longevity and mortality biomarkers.

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Kristen Beavers, assistant professor of health and exercise science at Wake Forest and lead investigator of this study, led earlier, smaller studies where she scrutinized the planning and preparation of the participants' meals. For this study, though, with its greater number of participants, she wanted to find a more cost-effective method.

Consequently, the study asked those in the weight-loss group to use four meal replacements every day and to prepare two meals of lean protein and vegetables each day. The team allowed each participant one healthy snack per day to wrap up a low-calorie, high-protein meal plan. Those in the other group were instructed to maintain their regular diet and usual activities.

Older adults and nutrition

Older adults have unique nutritional needs and may need to make changes to their diets as the years go by. Muscle mass can decrease as a natural part of aging, and people do not burn calories at the same rate as they do during their younger years.

Targeting nutrient-dense foods is essential for older adults, and avoidance of high-calorie foods that lack vital nutrients is crucial.

Beneficial foods include fruits, vegetables, whole grains, lean meats, seafood, poultry, eggs, legumes, and low-fat dairy. Portion control may also be necessary — for older adults especially — as people may eat more food than they need.

It can be challenging to cook for a smaller family, so experts sometimes suggest cooking ahead and freezing portions to eat later when cooking is less appealing.

The particulars of this latest study seem to mirror the nutritional needs of older adults. However, the authors suggest that the addition of more protein may be the key to avoiding some of the unhealthful pitfalls that can take place when an older adult loses weight.

"This study suggests that a diet high in protein and low in calories can give seniors the health benefits of weight loss while keeping the muscle and bone they need for better quality of life as they age."