Whooping cough

Pertussis(whooping cough) is back in the news.  Actually, it’s never left.  In California (where else?) there were more cases reported in 2014 than in any year since the 1940’s.  In our modern world, where pertussis is far less common, there is a certain complacency about this disease. This is wrong!  Pertussis in infants and young toddlers is a killer (> 100,000 cases/year 1940-5 before the vaccine, 8,000 deaths) and complications are not uncommon.  I have seen pertussis in an infant when I was a resident, and it’s not an easy thing to watch.

There are a few points about incidence by age group to note.  First (of course) infants under 1 year have the highest incidence(174.6/100,000), but adolescents are not that far behind (137.8/100,000).  Here and here are summaries of studies documenting the high frequency of pertussis in adults with chronic cough.  This is because the “acellular” vaccine, which replaced “whole cell” vaccine for children in the early ’90’s and became available for adults in 2005, is milder but somewhat less effective than its predecessor.  Immunity from the modern immunization (DTaP and TdaP) begins to wane after 3-5 years as opposed to 7 years for the older, stronger version.  So we have replaced lesser side effects for slightly less efficacy.  This is fine, mostly, as long as we remain vigilant.  That means keeping track of immunization records for your entire family–yourself included– especially for women who are or may become pregnant. So be sure to review your shot records with your own primary care doctor.

I can look over your own shot records as well.  As a service convenience to my patients’ families, I offer “catch up” immunizations for adult household family members under specific circumstances (as the saying goes “certain restrictions apply”).  Please check with us about your shot record if you wish when you come in for your child’s regular physical examination.

I invite questions or comments.  Thanks for following along.

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