White Coat Underground

Whooping cough on the rise

Apparently, it’s time once again to remind people why vaccination is important. Pertussis (“whooping cough”) is a nasty vaccine-preventable illness that is highly contagious and can be deadly to little ones. And it’s making a comeback. The Michigan Department of Community Health is tracking this disturbing trend:

Michigan saw a significant increase in reported cases of pertussis (whooping cough) in the second half of 2008 compared to the first half of the year, prompting officials to remind parents and doctors of the importance of vaccinating infants as well as teens and adults against this serious disease.

As of the end of December, a total of 307 cases had been reported in Michigan, although that number is subject to change as work continues to finalize case investigations. More than twice as many cases (210) were reported in the July-December period compared to the first half of the year (97). In 2007 there were 292 pertussis cases reported in Michigan.

“Pertussis is a vaccine-preventable disease, and that’s why the single most important thing parents can do is get their infants vaccinated and follow the schedule for booster doses,” said Janet Olszewski, director of the Michigan Department of Community Health.

This year is already on course to be one of the worst years ever. Let’s review why we should care about pertussis.

Bordetella pertussis, the cause of whooping cough, is a bacteria that only lives in humans. Therefore, if it can be wiped out in humans, like smallpox, we will never see another case. Universal vaccination is the only way to accomplish this.

Why should we?

Whooping cough, used to be a widespread disease. It is fairly benign in adults, causing a bronchitis-like illness, but children are at high risk of becoming very ill. The greatest risk is for children under 6 months old. If they get pertussis, they almost always need to be hospitalized. Pneumonia occurs in about a quarter of them, seizures and brain damage in about 3-5%. Death rates are about 1-2 in 1000. Serious allergic reactions to the vaccine occur in less than one in 100,000 cases. If you are unvaccinated and live with someone who has the disease, you will catch it (80-100% transmission rate). Vaccination prevents disease most of the time, and when it does not, lessens the severity. Most importantly, vaccination prevents transmission to those most vulnerable…babies. They are too young to have developed proper immunity. So getting vaccinated is not just for personal protection; it is for the protection of others.

Isn’t there another way?

No, not really, other than taking the same approach as we did to smallpox and wiping the disease off the face of the earth. Besides, vaccination is safe and effective…we already have a way to fight this. The problem is, the vaccine’s effects do not last forever, and if an adult catches it, it looks a lot like a common cold. There is no way to isolate them to prevent transmission. Vaccinating everyone protects our most vulnerable, and failure to vaccinate everyone puts our infants at risk.

How does this affect me?

Get vaccinated. Get your kids vaccinated. Prevent tragedy. When you go for your next tetanus shot (every 10 years), ask about the TDaP, a new tetanus vaccine which also boots your immunity to pertussis. And before you buy in to anti-vaccine hysteria, do your homework. Vaccination is your civic duty. It’s also your duty to spread the word. Tell your neighbors, your friends, your family. Vaccinate. Save a life.

CDC Pertussis Information

More pertussis information

Comments

  1. #1 dean
    February 6, 2009

    Very good points, but be prepared for an onslaught from the medically, scientifically, logically, and morally handicapped folks with the “but vaccines are bad because …” screeds.

  2. #2 D. C. Sessions
    February 6, 2009

    A while back I looked up recordings of babies with pertussis.

    The reason that you don’t hear them as sound tracks on public-service spots is because almost nobody can stand to listen to them for thirty seconds — people change channels.

    Thirty seconds.

    A case of pertussis lasts about three months.

  3. #3 Stephanie Z
    February 6, 2009

    Minnesota’s bad this year too. We have friends whose 10-year-old(?) son has it.

  4. #4 Donna B.
    February 7, 2009

    Thanks for the reminder about adult vaccines. It’s something I’ve let slip.

  5. #5 Heraclides
    February 7, 2009

    Ditto in New Zealand:

    http://www.stuff.co.nz/thepress/4834111a19753.html

    Whooping cough surge brings epidemic fears

  6. #6 Lora
    February 7, 2009

    “It is fairly benign in adults, causing a bronchitis-like illness”

    Uh, got to disagree there. I had it as an adult when my childhood vaccines wore off. Caught it from a co-worker who didn’t have enough sick days to stay home for the entire length of her illness, and infected the whole office. I thought I was gonna die. Definitely way worse than bronchitis. The abdominal cramps are the worst, because you’re trying to breathe AND cough AND you’ve got what feels like a giant charley horse in your torso. You can’t stop coughing long enough to eat or drink much, either, so you lose a lot of weight (in a bad way), and obviously sleep is impossible. On the plus side, you don’t notice the usual whole body ache of dehydration, because the fever and sleep deprivation will render you semi-conscious after about 48 hours.

    Get a booster shot. You may have to beg and plead with patronizing idiots who still think that childhood vaccines last a lifetime (I did), you may have to pay extra because lots of adult primary care docs don’t stock any vaccines other than flu shots, but get that booster shot however you have to do it.

  7. #7 SimonG
    February 7, 2009

    My younger sister had whooping cough when we were both young, back in the mid-60s. Not a terribly bad case of it, fortunately. (The doctor reckoned I also caught it but had an extremely mild case of it.)
    I remember having various other typical childhood ailments; chicken-pox and measles, certainly. Neither one terribly bad. (Although my dad caught chicken-pox from my sister and me, and was laid up in bed for a week.)

    The frequent mildness of these diseases is one of the problems. Like me, lots of people had one or more childhood illnesses without any great fuss. They just assume that their own experience is all that anyone has to worry about. I’d lay odds that few if any vacicne deniers ever had a serious illness in their youth.

  8. #8 khan
    February 7, 2009

    I’m due for my next TD booster in 2013, and will get the pertussis also.

    I think I may have had pertussis in my mid-40s; was doing some serious coughing for a week with no cold symptoms.

  9. #9 Noadi
    February 7, 2009

    I happen to be one of those unlucky people who even though I was vaccinated as a baby got whooping cough when I was 6 (missed huge chunks of 1st grade). My chest hurts just remembering it. No vaccine is 100% effective which is why herd immunity is so important.

  10. #10 JP
    February 8, 2009

    When I was in college, I caught what appeared to be whooping cough. There was never a positive diagnosis during the illness, just a retrospective estimate of the most likely cause. I was allergic to the whole-cell vaccine as a kid and only received two doses, so any immunity I might have had was long gone by college.

    The worst part of it was the coughing attacks, which went on for 2 months. There was a week or two where a few minutes after I woke up I would have a terrible coughing fit, some ending with the characteristic whoop, others ending with a vomit.

    The Dean of Students gave me an excuse slip for “unidentified respiratory illness”. The end date was blank, which proved quite helpful as the coughing dragged on and on…

  11. #11 leigh
    February 8, 2009

    my tetanus immunization expires in a month. whooping cough sounds pretty nasty, i’ll ask about the TDaP. thanks for the tip.

  12. #12 The Perky Skeptic
    February 8, 2009

    I got the TDaP in October or November, alongside my flu shot. Still reminding my husband to get his booster. Our child is fully up to date on his vaxxes. My father had Pertussis as a child– Do Not Want!

  13. #13 AnnR
    February 10, 2009

    The daughter of someone at church had it. She missed half a semester of high school and got all messed up going to college. She coughed so much the blood vessels in her eyes broke.

    Not fun. If you love your children you have them vaccinated.

  14. #14 cathryn adams
    April 8, 2009

    Right now whooping cough is sweeping the North East. It doesn’t seem to notice who has been vaccinated, and who hasn’t. It will never cause the extent of brain damage and death that DPT shots do. Start caring about something other than money and obsession with medical people

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