One of the greatest concerns amongst parents of young infants is whooping cough – typically only a 100-day coughing nuisance in teens and adults, but a potentially fatal illness in infants. Pertussis, also known as whooping cough, is a highly contagious respiratory disease caused by the bacteria, Bordetella Pertussis.
Known for uncontrollable, violent coughing fits, the reason for the name “whooping” is due to the sound an infected individual makes when taking deep breaths between coughs. Typically the coughing phase is preceded by a two-week period of runny nose and cold-like symptoms (and this is when the disease is most contagious -before the characteristic cough). And it is called the “100 day cough” for good reason. The coughing fits can last up to 10 weeks, even with treatment!
Pertussis can affect people of all ages, but can be very serious, even deadly, for babies less than a year old as they are very susceptible to developing a severe complication known as pulmonary hypertension, leading to hypoxia (low oxygen and turning blue) and eventual heart and lung failure. Hence, the growing concern of rising Pertussis rates in the US and the risk to our babies.
Treatment
Pertussis is generally treated with antibiotics, such as azithromycin, which are used to control the symptoms and prevent infected people from spreading the disease. However, antibiotics are often not sufficient to prevent severe complications in infants!
Prevention
The most effective prevention is from vaccination with DTaP (Diptheria-Tetanus-Acellular Pertussis) for babies and children and with Tdap for preteens, teens and adults. Tdap is particularly important in pregnant women to help protect infants as more than 50% of infected infants contract the disease from their mothers. Unfortunately the rates of Pertussis are rising, perhaps in part due to the weaker component of acellular Pertussis vaccine now used in today’s formulations. (Insert NY times article here as a link!)
Can someone with the vaccine get Pertussis?
Vaccinated children and adults can become infected with and spread Pertussis. However, the disease is typically less serious in vaccinated individuals.
Known facts, according to the CDC
- Worldwide, there are an estimated 16 million cases of pertussis and about 195,000 deaths per year.
- In 2012, the most recent peak year, 48,277 cases of pertussis were reported in the United States, but many more go undiagnosed and unreported. This is the largest number of cases reported in the United States since 1955 when 62,786 cases were reported.
- Since the 1980s, there has been an increase in the number of reported cases of pertussis in the United States. In 2010, an increase in reported cases among 7 through 10 year olds was seen. Similar trends occurred in the following years; however, an increase in cases was also observed among teens.
Why so many cases amongst teens?
A recent study by Kaiser Permanente’s Vaccine Study Center found within three years of vaccination with the new version of the acellular pertussis vaccine and booster, teenagers had lost virtually all of the vaccine’s protection, and more than 90 percent were susceptible to infection. Why? Prior to the 1990s, the pertussis vaccine was a whole-cell pertussis vaccine called DTP; however, reaction rates were commonplace. Hence, the vaccine was altered to a form without whole cells (acellular) called DTaP. The teenagers had received only the newer form of the pertussis vaccine and booster.
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