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New effort to cut whooping cough

(Journal)
(Journal)
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All pregnant women need to get the Tdap vaccine to protect their newborn infants from whooping cough. The new blanket recommendation issued by U.S. health officials follows a jump in the number of cases of whooping cough, also called pertussis, in New Mexico and nationally to the highest levels since the 1950s.

The New Mexico Department of Health confirmed 874 cases of whooping cough in 2012, or about three times the 2011 figure.

Whooping cough also took the lives of two New Mexico children last year — the state’s first deaths from the bacterial illness since 2005.

“The big danger is to infants, and particularly young infants” ages 4 months and younger, said Dr. Joan Baumbach, the agency’s medical epidemiologist.

Infants receive their first pertussis vaccination at 2 months of age, and they don’t complete the series until as late as 18 months.

In those early months, “infants are so vulnerable to complications, including death,” Baumbach said.

Women vaccinated after 20 weeks of pregnancy transfer pertussis antibodies to their newborn infants, helping protect babies until they complete their own vaccine series, she said.

The new recommendation, published Thursday by the Centers for Disease Control and Protection, replaces a prior recommendation that called for pregnant women to receive the Tdap booster only if they had not previously received it.

The Tdap vaccine protects against tetanus, diphtheria and pertussis.

Infants and young children should receive a primary series of vaccines called DTaP, at 2 months, 4 months, 6 months and 12-18 months of age.

New Mexico has consistently beat the national rate for Tdap vaccinations, which is required for school entry in grades 7 to 12. A 2011 survey found that 72 percent of the state’s school-age children get the booster.

New Mexico lacks data on the number of pregnant women who receive the Tdap booster, but anecdotal reports suggest New Mexico needs to do better, Baumbach said.

(Journal)

“We would like to see it much more routinely administered by health care providers who are caring for pregnant women,” she said.

Pertussis cases jumped nationally last year. The CDC reports that about 41,000 cases were reported to the federal agency, up from 18,719 cases in 2011. Most of the nation’s 18 pertussis-related deaths in 2012 were among infants younger than 3 months.

In addition to pregnant women, anyone who expects to be around infants should receive the booster shot, including family members, babysitters and health professionals, she said.

Even those who have received the booster should keep their distance from infants if they have cold symptoms or an upper respiratory infection.

Symptoms of pertussis usually appear four to 21 days after exposure, beginning with a runny nose, sneezing and a mild fever. The cough may be mild at first but typically worsens into an uncontrolled cough that can last for months.

If your baby is having trouble breathing, take him to a hospital or doctor right away, she said.

“I would say that anyone who even has what they think is a cold and they’re not very sick, they shouldn’t be around young infants because they might be carrying pertussis,” Baumbach said. “You might not even have started to cough yet, and that’s when you’re most infectious.”

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