Over the past decade or so, much ado has been made about vaccinations. Because of this, many people in our community are under vaccinated resulting in potential for outbreaks or epidemics. In 2010, more than 27,000 cases of whooping cough or Pertussis reached levels not seen since 1959. California had 10 infant deaths during this time. Washington, Minnesota, Wisconsin and Vermont declared epidemics and for 2012 had 3 times more cases than other states. In 2012, the CDC reported over 39,000 cases of pertussis in the US with 16 deaths.
What is whooping cough or pertussis? It is a highly contagious bacterial infection caused by Bordetella pertussis. In China, it is known as the cough of 100 days. It is spread through coughing and sneezing in close contact with others. The incubation period for this disease is 7-10 days. Cold-like symptoms with maybe a mild cough or fever present initially. Severe coughing develops after 1-2 weeks and can last up to 8 weeks. Paroxysms of cough are a violent rapid coughing fit over and over until the air is gone from the lungs. The lungs then produce that “whoop” sound giving the disease its name. These coughing fits cause extreme fatigue and vomiting. The child may appear “cyanotic” or blue from lack of oxygen. The cough is frequently worse at night. With infants, the disease is worse. More than half of infants less than a year must be hospitalized. Infants can also develop “apnea” or a pause in breathing which can be catastrophic. The convalescent stage lasts about 2-3 weeks and recovery is gradual. If not hospitalized, treatment includes supportive measures and antibiotic therapy. Hospitalization includes oxygen, intravenous lines, intravenous antibiotics, suctioning or removal of mucous from the breathing passages. Even with all our advances in medicine, this disease takes weeks and weeks to resolve.
The single most important way to prevent this disease is to get vaccinated with Tdap. The CDC and ACOG have on line the vaccination schedules for Americans. For pregnant women, ACOG recommends vaccination with Tdap after 20 weeks or better yet, between 27-36 weeks of pregnancy. You can discuss this vaccination with your obstetrician, pediatrician, and/or your primary care physician. If you did not get your vaccine during pregnancy, you can get your shot after delivery at Mary Washington Hospital or Stafford Hospital prior to going home.
In America we have been vaccinating for many years. Most of us, including the medical community, have not had to deal with those childhood illnesses of past such as polio, mumps, measles, chickenpox, and whooping cough. We have immunized ourselves against how horrible these diseases really are to families and children. People can get very ill. Recovery can be very long. There may be long lasting serious side effects, and for some there is a shortened life.
Because of immunizations, most of us have seen a sick child with a self limiting viral infection or a mild bacterial infection that responds quickly to appropriate treatment. The most our children will be really, really sick will only last a few days. At the most, we’ll spend a sleepless night or two or take a couple of sick days to care for our child. Yes, we will be worried. Yes, we will even feel how ill our child feels. We may even take our child to the doctor. We may have to give our child medication for a few days. In a few days, our child will behave as if he or she were never sick. A child with whooping cough will be sick for 100 days. If you and your child are vaccinated, you will never know the horror and agony of this disease.
Cynthia Wilkes MD
Stafford Womens Health Associates