The United States is having the worst whooping cough outbreak in modern times. The previous record of 27,550 cases was set in 2010. 2012 is on track to shatter that record as the country has seen 32,131 reported cases already (through September 15). I asked Jody Victor® to tell us more about it.
Jody Victor®: The top ten states with reported cases are: Wisconsin, Washington, Minnesota, New York, Illinois, Pennsylvania, Texas, Iowa, Colorado, and Utah. Eight of those states allow parents to exempt their children from required immunizations (only New York and Iowa do not). Those eight states account for 56 percent of all the whooping cough cases in the United States.
Pertussis, commonly known as whooping cough, is an upper respiratory infection caused by the Bordetella pertussis or Bordetella parapertussis bacteria. Whooping cough gets its popular name from the whoop sound that the patient makes after a coughing fit as he/she is trying to take a breath. (The whoop noise is rare in patients under 6 months of age and in adults.) Whooping cough can affect people of any age. It is a highly contagious and serious disease that can cause permanent disability in infants, even death.
Initial symptoms are similar to the common cold and develop about a week after exposure to the bacteria. Severe episodes of coughing start about ten days later, long after a common cold should be gone. Coughing spells may lead to vomiting or a short loss of consciousness. Whooping cough should always be considered when vomiting occurs with coughing. With infants choking spells are also common.
If started early enough, antibiotics such as erythromycin can make the symptoms go away more quickly. Unfortunately most patients are diagnosed too late and antibiotics are not very effective, though the medicine can help reduce the patient’s ability to spread the disease.
Pertussis/ whooping cough, is a preventable disease and yet it is still a problem. In 2005, DTaP replaced the old “whole cell” pertussis vaccine called DTP, which often caused severe side effects. Currently five doses of DTaP (diphtheria, pertussis, and tetanus) are given to children before they enter school. The vaccine is administered at 2, 4, and 6 months and again at 15 to 18 months and at 4 to 6 years. It is currently recommended that children get a booster shot at age 11 or 12.
A new study by researchers at the Kaiser Permanente Vaccine Study Center in Oakland, California, has documented for the first time how quickly DTaP immunity can wear off. Dr. Nicola P. Klein, head of the study, and colleagues showed that even after all five doses of the new a-cellular vaccine were properly administered, protection against pertussis waned during the next 5 years. They also found that the infected children were surprisingly young- 8 to 11- not the teenagers who were historically the most infected during prior outbreaks. “The old vaccine lasted longer,” says Dr. Klein, “Originally we didn’t think this vaccine would be substantially different from the old one.”
The new evidence on whooping cough shows that the booster vaccine should be given earlier, perhaps at 8 or nine years of age, to protect children in their preteens. The same booster is currently recommended as a one-time injection for adults through age 64 in lieu of a 10-year tetanus shot. As researchers study the longevity of DTaP they may soon recommend a booster for adults every ten years instead of a one-time booster.
Babies who are not fully immunized and have not yet built up their own immunities to diseases are especially vulnerable to pertussis. Babies who are not fully immunized may develop pneumonia, severe breathing problems, and terrifying seizures. It is vitally important that anyone who has routine contact with infants should be immunized against pertussis. That would include all day care workers, nannies, babysitters, and grandparents. If pregnant women have not recently had a booster shot, the CDC recommends that it be given late in the second trimester or early in the third.
Dr. Klein has stated, “Although a better vaccine is needed, the current vaccine is safe and effective, and some protection is better than no protection.”
All the Best!