Whooping cough, or pertussis, has made the news for months now, most recently as it took the life of another baby in California. The state has had more than 7,800 confirmed and probable cases (and likely many more unconfirmed). Tragically, 10 California infants have now died. All of the babies were under 3 months of age, and nine of the 10 babies were under 8 weeks -- which means they were too young to be vaccinated to protect against the infection.
California is not the only state seeing a rise in whooping cough. It's occurring all over the country. My hometown of Austin, Texas, has reported several cases recently, and Texas is second only to California in reported cases. Believe me, I am seeing plenty of kids in my office who have been exposed to a child with confirmed whooping cough. Parents are concerned, with good reason, and want their child to be checked out.
So, why are we seeing such a rise in whooping cough right now? Isn't it a vaccine-preventable disease? Is it simply because some parents are choosing not to vaccinate their kids? Well, it would be terrific if 100 percent of children were vaccinated, but it's not that simple a solution. Infectious diseases are much more complex. Here are some important facts about whooping cough:
1. Whooping cough epidemics occur in cycles and tend to peak roughly about every three to five years. The last major epidemic was in 2005, so we were destined to see an uptick in infections this year.
2. Immunity to whooping cough does not last forever -- even if you are vaccinated for protection or you had the disease before. Immunity wears off over time (listen up, adolescents and adults!). That's why it is so important to get the whooping cough booster vaccine, called Tdap (for tetanus, diphtheria, and pertussis).
3. Babies cannot receive their first vaccination for whooping cough until they are 2 months old. Even then, they do not have adequate immunity until they have received at least three doses of whooping cough vaccine DTap (at 6 months). So, babies rely on those around them to be protected by vaccination and not spread the infection to them. Up to 80 percent of babies get whooping cough from a loved one in their household (most often, it's contracted from their moms).
4. Adults often don't know they have the illness. It may look like a common cold at the beginning of the infection; then it becomes a cough that just lingers (whooping cough is also known as the "100 Day Cough"). People are contagious up to about two weeks after the cough begins.
So, what can you do? Make sure your child is up to date on his shots and make sure you are, too. If you can't remember the last time you got your tetanus shot, you need to roll up your sleeve and get the Tdap vaccine. These are the latest recommendations from the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP):
1. Adults ages 65 and up should get Tdap if they will be around infants who are younger than 1 year of age. (Previously, only those ages 64 and younger were advised to get the vaccine.)
2. Adults ages 65 and up can get Tdap as their tetanus booster if they have never received Tdap before.
3. There is no minimum time frame between the dose of Td (for tetanus and diphtheria) and giving a Tdap booster (originally it was recommended to be five years between, then two years between).
Because of the latest major outbreak, California has expanded its vaccine recommendations beyond the standard vaccination schedule. Californians who are age 7 and up who are not fully immunized; women of childbearing age, before, during or immediately after pregnancy; and anyone who has contact with pregnant women or infants should receive a booster shot for whooping cough.
I know that many adult medical practices do not stock the Tdap vaccine, but ask for it, and your doctor may get it for you. If you cannot get it from your doctor, call around to your local pharmacy or even grocery store, if it has a pharmacy department.
In addition to being vaccinated, be sure to watch for signs of whooping cough:
1. A persistent cough after having symptoms of a common cold.
2. A hacking cough that is much worse at night.
3. Coughing spells that include trouble catching one's breath at the end of the spell, vomiting at the end of the spell, lips turning blue, or face turning red with the spell.
4. Making a high-pitched "whoop" noise at the end of the coughing spell.
5. A low-grade fever throughout the course of the disease.
Dr. Ari Brown is a pediatrician, a medical advisor for Parents magazine, and the author of Baby 411, Toddler 411, and Expecting 411. Read her blog, Baby 411 & Toddler 411.
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