Whooping Cough Epidemic: Do You Need A Booster?

by Paulette Avery, R.N., M.S.N., I.B.C.L.C.

Recently, the California Department of Public Health (CDPH) issued news that an epidemic of whooping cough may be the worst seen in this state in the past 50 years. Already, California has 1,337 confirmed cases through June of 2010, with another 700 cases under investigation. That compares to just 238 confirmed cases in the first six months of 2009. Sadly, three infants under three months of age have died of the disease this year.

Whooping cough, also known as pertussis, is a highly contagious bacterial infection spread through droplets produced when those who have it cough or sneeze. The disease begins with symptoms similar to the common cold: sneezing, congestion, runny nose, and possibly a mild cough and low-grade fever. But after two weeks, severe bouts of coughing may begin. Particularly in children with whooping cough, the cough can become violent, rapid, and repeated to the point that they must inhale with a loud whooping noise. Treatment with antibiotics will kill the pertussis bacteria, but little can be done for the cough.

According to an article in the Medscape Medical News, outbreaks of whooping cough occur on a cycle of every three to five years, when the protective effects of the pertussis vaccine begin to wear off in the general population. The last outbreak in California occurred in 2005.

Vaccination remains the best protection against whooping cough. Recommendations are for all infants to receive the DTaP (diphtheria, tetanus, and pertussis) vaccine at two, four, six, and 12-18 months of age, with a booster at four to six years old. The first three doses provide infants with the maximum level of protection and as a result, infants younger than six months are those most likely to get whooping cough. Children 11 to 12 years old should also receive a booster of Tdap, the booster for adolescents and adults.

This epidemic developed despite our state's 97.8 percent DTaP vaccination rate in 2008 for children 19 to 35 months, a rate higher than the national average of 96.2 percent. Health officials believe adults are the population most responsible for spreading whooping cough to infants. In an effort to combat the epidemic, the CDPH has shipped free pertussis vaccine to all birthing hospitals in the state, as well as to county and municipal health departments. The CDPH recommends that parents and other family members of babies less than six months old, healthcare workers, childcare workers, and anyone else who has contact with infants receive the vaccine.'

Kaiser Permanente recommends that pregnant women in their second or third trimester, women who plan to get pregnant, and children 10 or older who have not had the Tdap booster should also receive the vaccine now. Please contact your doctor and get vaccinated to protect yourself and others from this unpleasant and potentially deadly disease.'

Paulette Avery is a registered nurse and a freelance writer who specializes in health issues.