Friday, August 16, 2013

Whooping Cough Spreading Through Texas

By Don Murphey, MD
Medical Director, Pediatric Infectious Diseases
Cook Children's Medical Center
Member, TMA Committee on Infectious Diseases

Dr. Murphey is responding to the Texas Department of State Health Services (DSHS) release reporting 1,670 cases of pertussis to the Centers for Disease Control so far this year. If cases continue to be diagnosed and reported at the current rate, Texas will report the highest number of pertussis cases it has had in more than 50 years, according to DSHS. Two infants, both less than two months old and too young to receive the pertussis vaccine, have died after becoming infected. Because children cannot receive the pertussis vaccine until two months of age and are not fully protected until they are 6 months old, it is critical that adults and older children who are in contact with infants get vaccinated to protect and “cocoon” the infant from harm.

Here in the Fort Worth area we have seen a big jump in the number of kids with whooping cough. We have had many more infants hospitalized with pertussis in the last couple months, and the number seems to be stable, not dropping. We now remember why pertussis is called the “100-day cough,” as coughing fits due to pertussis infection can last for up to 10 weeks or more.

We often see pertussis peak in the summer every few years. The outbreaks of pertussis in many areas of the United States over the past 10 years or more are related to incomplete protection from pertussis in adults and young children. Most kids are protected from about 6 months old to about 10 years old with the routine childhood immunizations.

What we are seeing now is that teens and adults with a mild cough illness spread this very contagious infection to infants, who have complications like coughing spells with inadequate respiration and low oxygenation. This can lead to further heart and brain injury. This is a problem we all need to be aware of. We need booster doses of Tdap to protect teens and adults.

  • The new recommendation to immunize pregnant women against pertussis after the middle of their pregnancy has still not been embraced as well as we would hope. We strongly urge families expecting new kids to ask their OBs or family physicians for Tdap for mom, and have the other family members immunized if they haven’t been already.  
  • Every adult who has not had one dose of Tdap vaccine should go get one to help build up community protection from the spread of very mild whooping cough in adults before it is spread to infants who can have devastating disease.  
  • We hope that all health care workers have had one dose of Tdap to protect them and their patients.  

Hopefully with better immunization we can prevent any prolonged illness and serious injury to our infants.

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