Fighting the whooping cough epidemic
Posted July 7, 2010
UC Davis Health System is responding to California's whooping cough epidemic with a series of measures designed to ensure that all patients and their families have adequate information about who should be inoculated to diminish the spread of the disease, particularly among infants and young children.
"Our approach to the whooping cough epidemic has been education, education, education," said the health system's Chief Medical Officer Allan Siefkin. "Whooping cough is a disease that is preventable by keeping vaccinations in children and adults up-to-date. Our goal is to ensure that our physicians are aware of it, don't miss the symptoms and encourage patients to get vaccinated. The whooping cough booster shot is also available for health system employees free of charge from Employee Health Services."
The California Department of Public Health declared a pertussis epidemic on June 18 after confirming 910 cases of the highly contagious disease since January 1, which resulted in the deaths of five infants less than 3 months old. While infants typically are inoculated against pertussis at two months, immunity is not conferred until six months of age.
Initial whooping cough symptoms are mild coughing, sneezing and a runny nose, which progresses to include severe spasms of coughing with the characteristic "whooping" sound as the child gasps in a struggle to breathe. Coughing spells may be followed by vomiting that can lead to dehydration and malnutrition. Other complications include ear aches, pneumonia and seizures. Whooping cough can take up to six months to resolve entirely.
“Adults may be at risk of getting whooping cough if the immunity conferred by childhood vaccinations has waned.”
— Stuart Cohen
"Clinicians in all UC Davis pediatric outpatient clinics, including its subspecialty clinics, routinely check to ensure all patients have up-to-date vaccinations," said Dean Blumberg, associate professor of pediatrics and chief of pediatric infectious diseases, who also serves on the statewide pertussis task force. "We also have increased efforts to assuage the fears of vaccine-hesitant parents about the importance of having their children immunized and have stepped-up testing to differentiate other upper-respiratory conditions from whooping cough."
To protect their newborns, women who deliver their babies at UC Davis are being offered booster shots while they are postpartum in the hospital. Parents are being counseled to ensure other children in their households have up-to-date vaccinations, and fathers are encouraged to get booster shots from their primary-care physicians.
Adults between the ages of 19 and 64 should have a whooping cough booster shot, said Stuart Cohen, professor of internal medicine and vice chief of the Division of Infectious Diseases in the Department of Internal Medicine.
"Adults may be at risk of getting whooping cough if the immunity conferred by childhood vaccinations has waned," said Cohen, who also is the director of Hospital Epidemiology and Infection Prevention. "While the disease is generally milder in vaccinated adults, keeping vaccinations current protects children and our community."
There is no formulation of the whooping cough vaccine designed for adults over age 64, but primary-care physicians may choose to inoculate older adults on a case-by-case basis. Older adults who are sick with a cough should avoid contact with infants and children until the illness subsides.
Recognizing whooping cough
Whooping cough is a bacterial infection caused by the bacterium Bordetella pertussis that is most serious in young children.
- First stage: Runny nose, sneezing, mild cough. This can last for one to two weeks.
- Second stage: Coughing worsens to include several forceful paroxysmal coughs, followed by a whooping sound as the child struggles to breathe. These coughing fits may be followed by vomiting, which can lead to malnutrition and dehydration. This can last for two to eight weeks.
- Third stage: A recovery phase lasting one to two weeks. Full recovery from whooping cough can take up to six months.
Resources for more information
- U.S. Centers for Disease Control and Prevention Whooping Cough website
- Hear what whooping cough sounds like
Infants and children up to 6 years old receive the whooping cough vaccination as part of the DTaP, or diphtheria, tetanus and pertussis inoculation. Vaccinations should occur at 2 months, 4 months, 6 months, 15-to-18 months and 4- to 6-years-of-age.
Pre-teens and teens who received the full childhood vaccination series receive the adolescent/adult Tdap vaccine between age 11 and 18.
Adults between age 19 and 64 receive a second Tdap booster vaccine, which stands for tetanus, diphtheria and acellular pertussis.