Vital Signs
Carolyn Poirot
Business Press Health Correspondent
cpoirot@bizpress.net
I’ve never thought of whooping cough as just a little more serious form of the common cold. I can still hear the sound of the strangled “whoop” one of my cousins would make at the end of what my mother called “a coughing fit,” when he stayed with my family to be near a doctor while recovering from whooping cough more than 50 years ago. He was an infant, but he still bears a faint scar on his lower neck where an emergency room physician cut a slit and inserted the breathing tube that probably saved his life. Even with the tracheotomy, he would gasp and struggle for breath, sometimes turning a blue-grey color during those scary coughing fits that continued off and on for months. Now, Dr. Sandra Parker, medical director for Tarrant County Public Health, says we are in the midst of the biggest outbreak of pertussis (whooping cough) in 50 years, and part of the problem is that we don’t take the disease seriously enough. Pertussis is most serious for babies who may not be able to eat, drink or breathe if they catch this disease, Parker warns. A potentially deadly bacterial infection, whooping cough can also cause complications including cracked ribs, pneumonia and seizures – and it is easily spread through coughing and sneezing among individuals in close contact with each other. Infants are at particularly high risk because of their immature immune systems and the fact that the first in the series of three TdaP (the combined tetanus, diphtheria and pertussis vaccine) shots cannot be given until a baby is two months old. Follow-up vaccinations are recommended at 4 months and again at 6 months and boosters at 15 to 18 months and 4 to 6 years, as well as one more at the age of 11 or 12. Early short-term protection is critical, Parker says. “Since the baby won’t get his or her first whooping cough shot until he or she is 2 months old, I recommend pregnant women receive a pertussis booster shot between the 27th and 36th weeks of pregnancy in every pregnancy,” Parker said. “This allows the mother’s body to make antibodies that will be passed on to the baby to provide some short-term protection early in life. Plus it prevents the mother from catching the disease and passing it on to the baby.” New mothers who did not get the whooping cough shot in pregnancy should talk to their health care providers about getting the shot as soon as possible after delivery. Actually, if there is a newborn baby in the family, every member in contact with the baby needs to have a booster shot of pertussis vaccine, at least every 10 years – more often than that if possible, since it’s better to be safe than sorry, several public health websites point out. Relatives and household members who will be in close contact with the baby, as well as all infant caregivers who have not had a recent pertussis booster, should also get one before the baby is born, Parker said. This is called “cocooning” as it surrounds the baby with people who will not give him or her the disease. I knew babies needed the initial series of three shots, toddlers get a booster at 15 to 18 months, and children should have a booster at 4 to 6 years as well as at age 11 or 12, but I had no idea that everyone who comes in contact with young children, including grandparents should be re-vaccinated until I met a new father who was waiting in line with me at Costco to get a flu shot. I was surprised when he said he was getting a flu shot and a whooping cough shot to help protect his family. No one is sure why there seems to be a resurgence of pertussis every five years or so, but in 2012, there were 2,218 cases in Texas, double the 2011 count of 961, and as of Oct. 7, there have already been 2,652 cases of pertussis confirmed in Texas this year, well on the way to another record. “As of Oct. 1, some 104 infants in Tarrant County have been diagnosed with pertussis, and 37 of those have had to be hospitalized,” Parker said recently. The total number of cases hit 433 in Tarrant County, 1,100 in North Texas Oct. 1, when the latest statistics were released by the health department. Tarrant County Public Health has prepared flyers and posters in both English and Spanish with a simple message: “Protect all your family against whooping cough. Get vaccinated now! Keep your baby away from anyone who is sick. If you are sick, don’t go near any babies. Get vaccinated against whooping cough.”