Jennifer Hohman, MD, Pediatrician
In the past couple of weeks there have been multiple cases of laboratory confirmed whooping cough in Van Wert County. Whooping cough is a respiratory illness caused by a bacteria called Bordetella pertussis. It is spread very easily from person to person through respiratory secretions, primarily coughing and sneezing. The illness typically starts out with a mild cough and runny nose. It can progress on to a severe cough that can last for several weeks or even months. Adults and teens infected with whooping cough can have mild or even no symptoms and can spread it to young babies and people who have not been vaccinated.
Vaccines to prevent whooping cough were developed in the 1940's and effectively reduced the number of cases by more than 80%. Since the 1980's, however, the number of whooping cough cases has steadily increased with over 25,000 cases in US in 2005. Infants typically receive the whooping cough vaccine beginning at age 2 months as part of the DTaP vaccine. The DTaP vaccine also protects against diphtheria (D) and tetanus (T). The final dose of DTaP is given at 4-6 years of age.
Unfortunately, DTaP does not offer lifelong protection against pertussis. Most people become susceptible to pertussis within 5 to 10 years after their last dose of vaccine. Even those who have had whooping cough are only protected for 7 years before their immunity begins to drop. This means that most teenagers and adults are susceptible to whooping cough.
Whooping cough can be especially severe in infants less than 12 months of age. Most infants who are diagnosed with whooping cough acquired it from a family member who did not know they were infected. In infants less than 2 months of age who develop whooping cough, 1% die from the infection.
Six children have died of whooping cough in Ohio since 2001, according to the Ohio Department of Health (ODH). Five out of the six fatalities were infants less than 12 months of age. Three of these were too young to have received any vaccinations. The final death was a 10-year-old child who had not received any immunizations.
There was a major breakthrough in the prevention of whooping cough in 2005 when two vaccines (Boostrix and Adacel or Tdap for short) were licensed in the US. They were deemed safe and effective against pertussis in adolescents and adults.
The Advisory Committee on Immunization Practice (ACIP) recommends that all persons between the ages of 11 and 64 years receive a single Tdap vaccine. This can be given at 11-12 years of age, when a tetanus booster is typically given. Older adolescents and adults should receive a Tdap vaccine if it has been more than 2-5 years since their last tetanus/diphtheria (Td) booster.
Vaccination is especially important for adolescents and adults with frequent contact with infants under 12 months of age. This includes parents, grandparents, healthcare workers and daycare providers. When possible, women should receive the Tdap vaccine before becoming pregnant. Pregnant women should get vaccinated as soon as possible after delivery of the infant. The Tdap vaccine should ideally be given 2-4 weeks before contact with the infant begins. Vaccinating these groups will help protect young infants who are not old enough to receive vaccines for whooping cough.
The Van Wert County Health Department administers Tdap vaccines. The cost is $10 for adolescents ages 11-18 years and for parents and caregivers of children less than 5 years. For all others receiving the vaccine, the cost is $55. Call 419-238-0808 to schedule an appointment.