What you Need to Know About Whooping Cough

Whooping cough, or pertussis as the docs call it, has made a roaring comeback in the U.S., and nowhere are the effects more devastating than here in California where the epidemic recently claimed its tenth little life — a 6-week-old ex-preemie who was too young to be protected by vaccines.

This dangerous respiratory infection is caused by a highly contagious bacteria known as bordetella pertussis. Early symptoms may be hard to distinguish from the common cold – runny nose, congestion, sneezing, red, watery eyes, a mild fever and coughing.  The coughs may have a high-pitched “whoop” sound when the sick person is trying to draw in the next breath of air.

The problem is that tiny babies – who aren’t protected from the illness until they’ve had the full series of immunizations by at least 6 months – almost never present with typical symptoms that would point to the diagnosis. More often they start out with non-specific signs like low-grade fever and irritability, followed by rapid breathing and cough — without the classic whoop that’s the tip-off in older kids and adults.

Right off the bat, the tiny guys are at a disadvantage in two big ways: inadequate protection and unrecognizable symptoms and signs. Add to that their immature immune systems that are still gearing up to deal with the big microbe-filled world, and you can see how it’s a set-up for the fight of their brand new lives.

So these little ones have to rely on other people who have been immunized to protect them from spreading the infection. In the medical community it’s generally agreed that if 90 percent of the population is vaccinated, the vulnerable are protected (so-called herd immunity). And since protection wanes and doesn’t last a lifetime, public health experts recommend that all teens and adults, particularly those who are around young babies, get pertussis vaccine boosters and that all children of vaccine age be reviewed to make sure their immunizations are up-to-date.

Which brings us to the question of parents who choose not to immunize their kids. Most parents who struggle with issues of whether and when to immunize are focused on what they see as the safest and best decision for their child.  Whooping cough is a perfect example of why this shouldn’t be the only consideration. Herd immunity is the only way to protect children who are too young or too ill to be protected themselves.

What should you do? Get vaccinated if you haven’t. Make sure your children are vaccinated. Anyone coming into contact with newborns needs to be vaccinated to create a “cocooning strategy” where newborns are protected because the older people around them have been vaccinated and won’t pass it on.

We can’t ignore this epidemic any longer. Babies are dying, and all of us are responsible.

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Rachel Zahn, MD is a pediatrician turned health writer who had three kids during medical school and pediatric training—crazy, huh?


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One response to “What you Need to Know About Whooping Cough”

  1. Trish Parnell

    We love you pediatricians! Thanks for writing about whooping cough. Sounds like something grandma had as a child, but it continues to circulate, waxing and waning in number of infections each year. We hope the teens and adults reading your post will check with their providers about keeping up-to-date with their vaccinations.

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