Whooping Cough Update: What You Need to Know

By Sandra Scalzitti, MD, pediatrician and internal medicine physician with Wheaton Franciscan Medical Group.

Pertussis, or whooping cough, is back in the news in Wisconsin. 86% of Wisconsin counties have reported a confirmed or probable case in 2012. And there has been a dramatic increase in case investigations in 2012 compared to 2011.

This appears to happen every few years. Pertussis can be a very serious illness for infants, which is why many hospitals (including Wheaton Franciscan Healthcare - All Saints in Racine and Wheaton Franciscan Healthcare - St. Francis in Milwaukee) are starting cocooning programs, in which parents and grandparents may get vaccinated. What may alarm some is that in at least one cluster incident (where there were more than 10 cases found in one school), some individuals were vaccinated. So, you might wonder, “how can someone who got the pertussis vaccine still contract the illness"?

The reality is that even the best vaccines are only 80-90% effective. They are not fool proof, but they are the best protection we have to contracting and spreading serious illnesses like pertussis. In fact, Wisconsin is doing better in vaccination rates than some states, since we require the 6th grade booster for school-aged children.

This week is National Infant Immunization Week, and its a great time to review the need for immunizations. Infants receive vaccinations for pertussis at 2, 4 and 6 months. A booster vaccination is given at 15 to 18 months and again at age 4 to 6 years. And, as mentioned earlier, it is now required to have another booster prior to entering 6th grade in Wisconsin. Adults should receive at least one pertussis vaccination, which is combined with tetanus in a vaccine referred to as “Tdap”.

Of the 1,187 confirmed and probable cases in Wisconsin as of March 28, 2012, 3% were hospitalized per state public health records. Of these, 61% were infants less than one year of age. Infants’ immune systems are not fully developed and require the three boosters to build up levels of adequate antibodies. And again, as with any vaccine, some people will not achieve adequate levels – even after getting boosters. The state reports 71% of our cases were considered up-to-date with their vaccinations. This can be due to inadequate response to vaccination, or the fact that older children and adults pertussis antibody levels decline over time.

Please consider vaccination for yourself and your families. If anyone has signs of pertussis encourage them to be tested and treated. Treatment works best in the disease’s early stages. Cough may have a whoop in young children. Children may also cough to the point of gagging or vomiting. Small blood vessels may break in the face and rib pain from coughing spells is common. Cough may last three months if not treated. Please see your doctor, provider or local public health department if you have any questions on vaccination. The Centers for Disease Control and American Academy of Pediatrics are also a wonderful sites with trustworthy information.

For more helpful health care information from our physicians, please visit our Wheaton Franciscan Medical Group blog.