Thursday, May 17th, 2012
Whooping cough (pertussis) is a serious (but preventable) disease that can be fatal for babies – in 2010 ten infants died from it in the state of California. There are periodic breakouts, such as the current one in Washington state, in which 1,484 cases have been reported through May 12 as compared to 134 cases during the same time period in 2011 (click here for the details from the Centers for Disease Control and Prevention). Given this recent outbreak, I thought it would be useful to share current information on whooping cough and advice on how to try to prevent it.
To this end, I sought out the perspective of Dr. Wendy Sue Swanson. Dr. Swanson sees patients at The Everett Clinic in Mill Creek, Washington and is on the medical staff at Seattle Children’s. Dr. Swanson is also a Clinical Instructor in the Department of Pediatrics at the University of Washington. In addition, she writes the Seattle Mama Doc blog, which I turn to frequently (as a professional and parent) for concise and up-to-date information and guidance on many pediatric issues. Dr. Swanson was kind enough to answer a number of questions I posed to her about whooping cough which I am pleased to share here.
1) What is whooping cough?
Whooping cough (also known as pertussis) is a highly contagious respiratory illness that can spread from one person to another with a single cough or sneeze. In older children and adults, it starts as a typical cold but can advance to a more prolonged/protracted cough that is serious, uncomfortable and disruptive. The cough can get so bad that it makes it difficult to eat, drink or even breath. Sometimes the cough causes a characteristic “whoop” and often it causes vomiting. But most dangerous is whooping cough in infants. In infants it can cause feeding delays, severe respiratory distress, pauses in their breathing and/or death. Infants under 6 months of age are at high risk, and those under 2 months of age are at severe risk for complications.
2) How is it spread?
Via coughing, sneezing, or other ways in which droplets spread from one to another.
3) Are children of all ages vulnerable?
Although infants are most vulnerable – particularly those under 2 months of age – all children are at higher risk. In Washington state during our epidemic, 80% of positive tests were in children under 18 years of age. That is primarily because it is more distressing to children and they are the ones who get treated. Most data supports the notion that during epidemics, only aboute 10% of those with whooping cough get tested.
4) Why do we see surges in it?
Whooping cough tends to cycle every 3-5 years with surges. Part of that has to do with immunity and the herd. Part of those surges have to do with the fact that we never develop lifelong immunity. After a whooping cough infection, our immunity to whooping cough wanes somewhere between 4-20 years and after the immunization it wanes somewhere between 4-12 years later. That is why it is recommended that all children over age 11 get a Tdap shot NOW. We also immunize infants with DTaP at 2,4, 6, 15 months and 4 years of age. It’s essential that pregnant women get the Tdap in their 3rd trimester (after 20 weeks gestation). All adults who will be around newborns should also get the Tdap. We know that newborns are most vulnerable to the serious complications from whooping cough so if we “cocoon” them with family and friends who are immunized we reduce the likelihood that they get an infection.
5) What symptoms should parents look for? What should they do when they observe these symptoms in their kids?
In infants, if your newborn or infant has a cold, difficulty feeding, vomiting with cough or coughing fits, see the pediatrician. In older children, if they have been exposed to whooping cough and present with a cold, or have a cough that lingers past 2 weeks, cough with vomiting, or a “whoop” sound, see the doctor immediately.
6) What should parents do to protect their kids and help prevent it?
The best way to protect against whooping cough is to get immunized (as detailed above). After you get immunized, ask that your family, your children’s daycare and school teachers, and all adults that come into your home get immunized, too. Grandparents of any age are recommended to get the Tdap shot, too!
If you would like to learn more, here are additional blog posts that Dr. Swanson has written on whooping cough:
Post on how to protect newborns:
What is the Tdap shot? (YouTube video and post w/list of resources):
All Grandparents need a Tdap shot: