Issue

Pertussis, aka “whooping cough”, has reached epidemic levels in Washington state and elsewhere throughout the country.  Whooping cough, an infection of the respiratory system, spreads from person to person easily and can be life-threatening.  Infants and children who haven’t been immunized can get seriously ill if they get whooping cough.

Public health officials are asking everyone to make sure they’re up-to-date with vaccines. It’s especially important for anyone who has close contact with babies younger than 12 months to get vaccinated to help protect the baby from whooping cough. This includes parents, siblings, grandparents, health care providers, and child care providers.

Experts believe a growing hesitancy toward vaccination in general,  as well as the fact that many adults don’t realize they need to get vaccinated against pertussis have contributed to Washington’s whooping cough epidemic.  Vaccination decreases the chance of contracting and spreading whooping cough.

Statistics

So far in 2012, 640 cases have been reported in 23 counties in Washington state as of March 31. This compares to 94 cases during this same time period last year, putting the state on-pace to have the highest number of reported cases in decades. Washington state public health officials believe the epidemic is under-reported and will probably affect many more people. They estimate only 10 to 12 percent of cases are reported.

National

  • In 2010, 27,550 cases of pertussis were reported in the U.S.

 Washington state

  • So far in 2012, 640 cases have been reported in 23 Washington counties as of March 31. This compares to 94 cases during this same time period last year, putting Washington on-pace to have the highest number of reported cases in decades.

Seattle Children’s

  • In the past 12 months (April 2011 – April 2012) at Seattle Children’s Hospital approximately 60 patients tested positive and were treated for pertussis – more than double the number seen in the prior year.
  • In comparison, in the prior year (April 2010 – April 2011), approximately 24 patients tested positive for pertussis.
  • Seattle Children’s started to see an increase in incidence in mid-December 2011 – 35 of the 60 positive tests (58%) in the past 12 months were identified since then, i.e. in the last 3 ½ months.

What the Experts Are Saying

  • ‘Infants younger than 6 months are most at risk of dying from pertussis. It’s important to “cocoon” infants by vaccinating the adults around them who might transmit the disease,’ said Ed Marcuse, MD, MPH, associate medical director of quality improvement at Seattle Children’s Hospital.
  • “It’s frustrating every year to see several children who die from  influenza or whooping cough when they didn’t need to,” said Douglas S. Diekema, MD, MPH, attending physician and director of education for the Treuman Katz Center for Pediatric Bioethics at Seattle Children’s Hospital.

Q&A: What Families Need to Know

What is whooping cough?

Whooping cough is an infection of the respiratory system. It’s caused by the bacterium called “B. pertussis” so another name for whooping cough is pertussis. Whooping cough spreads from person to person easily.

How can I protect my family from whooping cough?

You can greatly reduce the chance of you or your child getting whooping cough by getting the pertussis vaccine. It’s part of the DTaP vaccine which is given in 5 doses, most often at 2 months, 4 months, 6 months, between 15 to 18 months of age, and again between 4 to 6 years of age.   All doses are needed for the best protection. For children age 6 and under, follow the vaccine schedule recommended by your healthcare provider. For people ages 11 to 64, a one-time booster shot (Tdap) is recommended.

How can I protect my child who hasn’t had all of their immunizations yet?

You can protect newborns and children who haven’t yet had all of their immunizations by making sure your child’s caregivers and others who live in the home are fully vaccinated. Ask your child’s healthcare provider if you have any questions about the vaccine or the dose schedule. Also call your child’s healthcare provider if either of you have been near someone with whooping cough. Make the call even if you’ve had all of your immunizations. Your provider will likely prescribe antibiotics to prevent you from getting whooping cough.

Where can I get my child vaccinated?

In Washington state, all recommended vaccines are offered at no cost to all kids under 19 through health care provider offices participating in the state’s Childhood Vaccine Program. Health care providers may charge an office visit fee and a fee to give the vaccine, called an administration fee. People who cannot afford the administration fee can ask their regular health care provider if they’ll waive that cost. Most health insurance carriers will cover the whooping cough vaccine; adults should double check with their health plan.

What does whooping cough look like?

Whooping cough symptoms often start out looking like cold symptoms. Runny nose, sneezing and coughing are the first symptoms in most people. After a week or two, the cough gets worse and coughing spells may develop. It can be hard to breathe during a coughing spell and your child may make a “whoop” sound at the end of a spell. The coughing spell may make your child vomit. Infants may not “whoop,” but may look like they’re having a hard time breathing and can turn red or bluish.

Is whooping cough a serious infection?

For babies, the infection can be very serious and require a hospital stay. Whooping cough can be life-threatening. Pneumonia, convulsions, dehydration and other complications may develop. For older children, adolescents and adults, though not life-threatening, the cough typically takes 2-3 to months to resolve; whooping cough has also been called the 100 day cough.

How is whooping cough treated?

Because whooping cough is caused by a bacterial infection, it’s treated with antibiotics. Unfortunately antibiotics do not speed recovery, but do prevent further spread. Follow the instructions from your healthcare provider carefully when given antibiotics. Children who are so sick with whooping cough that they require care in the hospital will be supported by giving them oxygen, IV fluids and treatments to suction secretions from their respiratory tract to help them breathe.

Immunization Experts Available For Media Interviews

Ed Marcuse, MD, MPH, associate medical director of quality improvement at Seattle Children’s Hospital. Nationally Dr. Marcuse has served as a member and Chair of the United States Department of Health and Human Services National Vaccine Advisory Committee, a member of the American Academy of Pediatrics Committee on Infectious Diseases (Red Book), Associate Editor of the Red Book, Chair of the American Academy of Pediatrics Immunization Advisory Team, a member of the CDCs Advisory Committee on Immunization Practice, a member of the Institute of Medicines Committee on the National Vaccine Plan and currently serves on the FDAs Vaccines and Related Biologics Advisory Committee. Dr. Marcuse has authored over 100 publications relating to immunization, general pediatrics, and public health and is a founding Co-Editor of AAP Grand Rounds, a monthly publication critiquing new studies relevant to pediatric practice.

Douglas S. Diekema, MD, MPH, attending physician and director of education for the Treuman Katz Center for Pediatric Bioethics at Seattle Children’s Hospital. Dr. Diekema is past-chair of the Committee on Bioethics of the American Academy of Pediatrics and serves on the Ethics Committee of the American Board of Pediatrics. He is nationally sought after as a lecturer. He has numerous local and national committee responsibilities, as well as an extensive bibliography.

Resources

Watch this compelling video about one mother’s nightmare experience with whooping cough and the role that vaccines play in protecting us:

If you’d like to arrange an interview with an immunization expert or a family affected by pertussis, please contact Children’s PR team at 206-987-4500 or press@seattlechildrens.org.