In many cases, it is hard to tell whether someone has a common cold, the flu or whooping cough. The flu and whooping cough are both preventable with vaccines, but the common cold is not. Other viral cough illnesses that affect young children include RSV and croup. But I am going to focus on whooping cough, more formally known as Pertussis, because we are seeing an increase in the number of cases reported.
The primary goal in dealing with Pertussis is to prevent infants from becoming infected. This is because infants and young children are at highest risk of developing severe complications from Pertussis and are more likely to die from it. This year, there have been thousands of cases of Pertussis in California and at least nine infant deaths as a result. In the last few months in Thurston County, we have had four infants diagnosed, but only two were hospitalized and both recovered.
Why do we continue to have Pertussis when there is a vaccine available? There are many reasons:
1. We have more families who are against vaccinations.
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2. While Pertussis vaccine is effective in preventing severe illness in infants, the vaccine immunity wanes after a few years. Older children and adults continue to harbor this infection and pass it on.
3. Older children and adults can become infected with Pertussis, but since symptoms are often milder, they may not be diagnosed and treated in a timely manner.
4. Treatment for Pertussis is effective if given early in the disease, but it is not easy to recognize.
5. By the time Pertussis is recognized, often a person has been spreading the infection for two weeks. Pertussis starts with cold symptoms and a slight cough for the first week or two, followed by increasing spasms of coughing, often causing a “whoop” sound, with a sudden gasp for breath after the cough. Infants might stop breathing. It is not uncommon for children to cough so hard that they vomit.
We consider this disease endemic in Thurston County. This means that the disease is always present.
Changing this depends on all of us actively working to decrease the spread of this disease, especially to newborns. That means we should vaccinate all children against Pertussis. The DTaP vaccine is typically given at ages 2 months, 4 months, and 6 months, with a booster at 12-18 months, and another before school entry.
A vaccine for older kids and adults was approved in 2005. The TdaP is recommended for teens 11-13 and for adults as a one-time dose to be taken in place of one of our every-10-years tetanus boosters.
Family members and caregivers of newborns should consider receiving this vaccine before the new baby arrives.
Treatment with antibiotics may be necessary to prevent disease after exposure, especially if there is potential increased risk to infants or young children.
Consider vaccination and encourage everyone to:
Cover their cough.
Wash their hands.
Stay away from others when they are ill.
Dr. Diana T. Yu is the health officer for Thurston and Mason counties. She can be reached at 360-867-2501 or firstname.lastname@example.org.