Pertussis: Nothing to whoop about

By DR. DAN BRENNAN — July 10, 2009

“Cough – cough – cough – cough - W-H-O-O-O-O-P! Cough – cough – cough – cough - GASP!” The baby’s face turns purple. She can’t catch her breath. She is in distress. Sound scary? It is. What’s going on? This infant is suffering from a potentially deadly, completely preventable case of whooping cough.

What is whooping cough?

While many people have heard of whooping cough, most are not aware that this deadly bacteria still exists and is on the rise in Santa Barbara. Whooping cough is caused by a very contagious bacteria, Bordetella pertussis, which infects the respiratory tract, causing a disease with three distinct phases that may last for over 100 days.

The first phase is indistinguishable from the common cold, with runny nose, sneezing and mild cough. This is the most contagious phase and may last up to two weeks.

In the second phase, the cough becomes more intense, leading to rapid sequence of coughs. The characteristic “whoop” signals the desperate need to breathe. Very young infants may not produce the “whoop”, but may turn blue and stop breathing. During this sequence of suffocating coughs the child’s brain may be deprived of oxygen, which may induce a seizure or cause permanent brain damage. This paroxysmal coughing phase can last up to four weeks and is the time when most complications arise.

During the final phase, the uncomfortable cough nags and slowly subsides over the course of many months.

Complications

Complications from pertussis are numerous and include pneumonia, seizures, permanent brain damage or even respiratory failure and death. Infants, especially under six months of age, are at the highest risk for these complications.

Treatment

By the time pertussis is typically diagnosed, little can be done to change the course of the disease. Treatment is largely limited to supportive care. Hospitalization is indicated for any child with severe coughing associated with pauses in breathing or lack of oxygen. Nasal suctioning and supplemental oxygen may be helpful. A breathing tube and connection to a ventilator may be required for infants who stop breathing, have respiratory distress or develop pneumonia. Antibiotics are given to prevent the spread of pertussis to close contacts. Unless administered very early in the course of the disease, antibiotics are not effective in the treatment of pertussis.

Prevention

Universal immunization with pertussis vaccine is recommended for all children. This vaccine is safe and effective for infants as young as 6 weeks of age. Given as part of the DTaP series, children should receive the vaccine at 2, 4, 6 and 15 months of age, followed by boosters between 4-6 years and again at 11 years of age.

Because an adult’s immunity to pertussis decreases over time, up to half of infants who develop pertussis actually catch it from a parent or close family contact. Thanks to a new vaccine that boosts the immunity for adolescents and adults to pertussis and tetanus, called Tdap, new parents can now help prevent the spread of pertussis to their newborns.

Vaccines are safe and necessary

Vaccines have been so effective in reducing childhood disease that some parents have a false sense of security and no longer see the need to immunize their children. In communities where childhood immunizations are declining, such as in Santa Barbara, the rates of vaccine preventable illness are making a comeback.

When more than 90% of children and adults in our community are immunized against diseases such as pertussis, then we significantly reduce the chances that we will have outbreaks in our community. Parents who choose not to immunize their children not only put their own children at risk, but place all of our children in jeopardy.

Childhood vaccines are safe and effective and do not cause developmental delays, such as autism. Please join your friendly community pediatricians and encourage your friends and neighbors to fully immunize themselves and their children against preventable diseases such as pertussis.

Dr. Dan Brennan is a board-certified pediatrician and Santa Barbara native who enjoys spending time with his wife and two fully immunized boys. His column can be found in the Daily Sound on alternating Fridays. Please contact him at 563-6211 or visit www.SBPediatrics.com.

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Adults need to be vaccinated too! : 7/10/2009

My whole family is immunized against this horrible disease! Yours should be too. I heard that many local schools had outbreaks at the end of the school year. This can be a deadly disease, especially for new babies. Adults need to get boosters too!

SB

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Pertussis : 7/10/2009

I had read about several babies dying during the last few years due to exposure to others who were old enough to be immunized and chose not to -- I made this a priority for our family as soon as our daughter was born -- we promptly called our doctors for the booster! We were also careful about not exposing her to children who were old enough to be immunized but were not prior to her receiving her pertussis imunizations since I knew catching whooping cough could be quite dangerous for a newborn and exposure to nonimmunized children is often how babies who are too young to receive immunizations become seriously ill. Dr. Dan --- keep all the helpful info coming and get the word out that not immunizing your kids puts other babies lives at risk who are too young to take advantage of life-saving immunizations!!!

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Gonna have a baby? : 7/10/2009

Get yourself vaccinated before you get pregnant. I had to wait until after I was done breastfeeding and am thankful that my daughter didn't catch anything from me when she was most vulnerable. I am on my husband's case right now to get his shot b/c I'm pregnant again. Do it for your kids!

Local mom

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Thank you : 7/22/2009

Thanks for taking a stand and advocating for immunizations. I am so grateful that you are our child's doctor. There is so much misinformation out there. It is nice to have a doctor that can take a stand, but do it in a genuine and gentle manner. The best thing about you is that we always feel that we are your only patients...even though we know that you are extremely busy. Thanks Dr. Dan!!!

SB Native

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