Whooping cough, also known as pertussis, is an extremely contagious respiratory infection caused by a type of bacteria called bordetella pertussis. It can cause serious illness in infants, children, and adults. Of the 194 United States pertussis deaths from 2000 to 2009, 152 were infants under the age of one month, and twenty-three deaths were in infants two to three months old. In the United States, pertussis is one of the most commonly occurring diseases that actually has a vaccine to prevent it.
Pertussis starts out like a common cold with runny nose or congestion, sneezing, fatigue, and possibly a mild fever or cough. But after one to two weeks, severe coughing can begin. Unlike the common cold, pertussis causes violent and rapid coughing, over and over, that causes the air to leave the lungs and forces you to inhale with a loud “whooping” sound. However, in infants, the coughing may be minimal or not even there. They may experience a symptom known as “apnea.” Apnea is a pause in the child’s breathing pattern. If you notice that your baby is having trouble breathing, take her to the hospital or doctor right away. To hear what pertussis or whooping cough sounds like, go to www.pkids.org/diseases/pertussis.html
The disease is spread by coughing or sneezing while in close contact with others, who then breathe in the pertussis bacteria. Many infants who get pertussis are infected by parents, grandparents, older siblings, or caregivers who might not even know that they have the disease.
What can we do to help prevent our children from contracting this serious illness? The answer is simple. Get vaccinated! The vaccine that is recommended for infants and children is known as DTaP. This vaccine protects children from three harmful diseases: diphtheria, tetanus, and pertussis. For maximum protection against pertussis, children should receive a total of five DTaP injections. The first three shots are given at two months, four months and six months of age. The fourth shot is given between 15-18 months of age and the fifth shot is given when the child enters school at four to six years old. A booster shot of Tdap should be administered at ages 11-12 years old. Don’t worry if you did not receive that booster shot as a preteen; you can get it at anytime. The protection from these vaccinations fades over time, and the easiest thing for adults to do is get a one-time Tdap booster instead of the regular tetanus booster (Td) that is recommended every 10 years. Also, the Tdap booster can be given earlier than the 10-year mark, so it is a good idea for all adults to discuss with their health care providers what is best for them. It is important to get vaccinated at least 2 weeks prior to coming in close contact with an infant.
The American College of Obstetrics and Gynecology recommends that women get vaccinated prior to becoming pregnant. If a woman becomes pregnant without the vaccination, she can receive one dose of Tdap booster shot during the third trimester or late second trimester, which is after 20 weeks or immediately postpartum, before leaving the hospital or birthing center. If you are pregnant or thinking about becoming pregnant, ask your health care provider about getting the pertussis booster (Tdap) to help provide protection until your newborn can receive the vaccination series.
For infants and children that have any pertussis symptoms, there is a PCR test that a pediatrician can perform to detect DNA of the pertussis bacteria. The test consists of a nasopharynx swab in the upper part of the throat. It is best to swab an infant during the first three weeks of symptoms when the bacteria DNA is present in high numbers. After the fourth week, the bacteria DNA diminishes rapidly and can increase the risk of false-negatives. It is not recommended to test other persons in the house if they do not have any symptoms.
Pertussis is typically treated with antibiotics. A child with pertussis may also require care in the intensive care unit for multiple reasons. Apnea, pneumonia, and seizures are the most common symptoms that will need ICU care. The bottom line is if your baby exhibits any behavior or symptoms that are not normal, don’t second guess yourself. Contact your pediatrician for further evaluation.
For more information, visit
Virginia Health Department at www.vdh.state.va.us
Parents of Kids with Infectious Diseases Pkids at www.pkids.org
American College of Obstetricians and Gynecologists at www.acog.org
Melissa Waddell, WHNP, a Hampton Roads native, is a nurse practitioner at Atlantic Ob/Gyn with locations in Chesapeake and Virginia Beach. For more information, please call 463-1234 or visit www.atlanticobgyn.com.