Pertussis is the scientific name for whooping cough, a respiratory infection that causes the most serious illness in infants. It was a common and sometimes fatal disease as recently as the first half of the 20th century.
A pertussis vaccine was first put into use in the United States during the 1940’s, leading quickly to a decrease in the number of cases, from 156 per 100,000 people to less than 1 per 100,000 people in 1970.
Most people are unfamiliar with this disease. Individuals with pertussis have repeated and long bouts of coughing, followed by taking in air and making the whooping sound. The whoop is something most people will recognize after they hear it. However, not everyone with pertussis makes the whoop.
This prolonged, severe, respiratory illness is known in many countries as the “100-day cough” and not whooping cough.
Vaccines
With all the currently available vaccines, huge strides have been made in decreasing many of the common childhood illnesses, from chicken pox to measles and polio. As children have been routinely vaccinated against pertussis via their DPT vaccines (diphtheria, pertussis and tetanus), the number of people getting whooping cough has decreased significantly. People don’t know about it or think about it.
As these diseases fade out of most people’s memories, they tend to think vaccinations might be less necessary. It is true that not each person needs a vaccine to prevent a common disease. If everyone else gets the vaccine, the person will not get exposed. If enough people in a community have been vaccinated, they have what is called “herd immunity.”
However, if not enough people get vaccinated, diseases like pertussis can spread through a community very quickly. Not only is there a danger in not vaccinating against pertussis, but if you don’t want your children vaccinated or to get vaccinated yourself, you are essentially counting on other people to do what you don’t want to do.
Some parents have concerns about possible side effects from a variety of vaccines, or all vaccines, even with their demonstrated effectiveness and safety. There is a system of reporting adverse effects of vaccination in the United States, and the FDA and CDC track problems carefully. All the vaccines are not only tested before they are licensed, but are followed to make sure they are safe. For example, the Vaccine Adverse Event Reporting System (VAERS) is used to report any adverse reaction to a vaccine. Anyone can report an event, and this information is collected and analyzed.
Unfortunately, routine vaccination of children has been questioned by many ill-informed or even unscrupulous individuals who spread these ideas to the public at large. One English doctor led the fight against the MMR vaccine (mumps, measles and rubella, or German measles) using fabricated data to “show” a relationship between the vaccine and autism. This doctor not only was found to have falsified data, but lost his license to practice medicine and was totally discredited.
Pertussis and vaccines
When pertussis vaccination rates started dropping in the 1980’s, pertussis became more common. Additionally, it was learned that childhood vaccinations do not give lifetime immunity, so pertussis has spread among adults as well as children. It is now recommended that adults get one booster shot along with their tetanus and diphtheria shot (Tdap). This can be given less than ten years from the last tetanus shot. It should definitely be given to adults who will be taking care of babies as soon as possible.
Pertussis is the most deadly in infants. Children need 5 DTaP shots, first at 2, 4, and 6 months old. Booster shots are given between 15 and 18 months of age, and then a fifth before a child enters school between the ages of 4 and 6 years.
The best way to protect very young infants is to make sure that all caregivers have been vaccinated against pertussis. Pregnant women who have not been vaccinated should be, preferably in their last trimester, the last three months of their pregnancy. That will protect them, as well as passing some immunity to their unborn babies.
Pertussis epidemics
There have been a number of pertussis epidemics since the 1980’s, usually every 3 to 5 years. At the current time there is a pertussis epidemic underway in the United States. All states are seeing an increase in cases, and some states have seen a large increase. The state of Washington declared an epidemic in April of 2012. Minnesota and Wisconsin have also seen high rates of the disease.
As a point of comparison, for 2012 up to July 5th, the average nationwide number of cases was 5.24 per 100,000 people. In Wisconsin, that number was 50.7 per 100,000 people; the number was 39.2 cases per 100,000 people in Washington.
Ten deaths have occurred mainly, in babies under 3 months of age. Infants have the highest rate of pertussis. Children 7 to 10 years of age and those 13 to 14 years of age also have higher than average rates of pertussis.
As described previously, pertussis is a respiratory illness during which coughing is severe and constant, and people, especially babies, have difficulty breathing. If you suspect your child might have this disease, seek immediate medical care. Pertussis can be treated with antibiotics.
The best thing, though, is to get the vaccine yourself as a parent or other caregiver, vaccinate your infants and children, and get recommended boosters.
References
CDC. Pertussis (Whooping Cough). Page last updated: July 19, 2012. Accessed July 20, 2012. http://www.cdc.gov/pertussis/outbreaks.html
Gregory, David S. Pertussis: A Disease Affecting All Ages. American Family Physician. 2006; 74(3): 420-6, 427.
Pertussis. Chapter 14. Epidemiology and Prevention of Vaccine-Preventable Diseases. The Pink Book: Course Textbook. 11th edition. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 2009. Pages 199-216.
VAERS. Vaccine Adverse Event Reporting System. Accessed 7/23/2012. http://vaers.hhs.gov/index