Search for tag: "pertussis"

Interviewer: What is pertussis, what can you do about and can adults get it? That's next on The Scope.

Announcer: Access to our experts with in-depth information about the biggest health issues facing you today. The Specialists with Dr. Tom Miller is on The Scope.

Interviewer: If you get a nasty cough that will not just go away it might be pertussis. The odds are slim but it could be. To find out more about pertussis in adults we're with Doctor Tom Miller here at University of Utah Health Care.

Pertussis; tell me a little bit about it and then tell me how an adult can get it.

Dr. Miller: Pertussis was commonly known as whooping cough and occurred most commonly in children prior to the development of an effective vaccine, and it was deadly. A lot of kids died of whooping cough in the old days.

Interviewer: Another one of these things that the vaccines have made a huge difference, and we forget about it, right?

Dr. Miller: We forget about it and actually what's happened is that kids all in the United States generally get this vaccination for pertussis and it effectively prevents it, but as we get older our immune system forgets about exposure to the vaccine and immunity wanes. And you know what? People coming into the country who are not vaccinated can bring pertussis in.

It's a very highly infective bacteria so you don't need much in the way of bacteria to become infected. And when you are infected, if you are older you could end up with not whooping cough but something called the 100 Day Cough.

For a few days you just feel real crappy. You feel very poorly, you have a sore throat and you develop a cough. It's awful. It's what we call paroxysmal cough. It's deep, it's rapid, it's unending and it's so bad sometimes that it will make you vomit, throw up. It's terrible.

So that's why the recommendation now is that as an adult you should receive a pertussis vaccine with your tetanus and diphtheria vaccine. You only need that once in adulthood but if you don't have that you then are at risk to pick up pertussis should you run into a child or even an adult who might be carrying pertussis. And again, it doesn't take much in the way of contact to develop pertussis.

Interviewer: So how is it transmitted?

Dr. Miller: It's transmitted through vapor droplets. Somebody coughing, they can pick up the bacteria in that way. And again, it's highly infective. Many times patients don't know they have pertussis when they are adults because they don't have this barking whooping cough that the kids used to get. They just start with a cold, but the severity of the cough is the thing that makes physicians think about it.

Now, you can treat the patient once they develop the cough and it can get rid of the pertussis bacteria but it doesn't get rid of the cough, and that cough goes on and on and on, and it's a devil to treat if you can even treat it.

Interviewer: So I guess the message here is if you haven't had that pertussis booster, you should get that.

Dr. Miller: Get the booster. Absolutely.

Interviewer: It is something you see on occasion.

Dr. Miller: I do see it on occasion. In Utah, we have an increase in the rate of pertussis in adults because of our immigrant population. They're not always vaccinated when they come into the country.

Interviewer: International Airport.

Dr. Miller: The simple way to protect yourself is to make sure you get that booster.

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updated: January 2, 2019
originally published: June 28, 2016

Dr. Gellner: Pertussis is the latest disease outbreak of concern in the United States. What do you need to know to protect your child as a parent? I'm Dr. Cindy Gellner and that is what we are going to discuss today on The Scope.

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Dr. Gellner: So the number of pertussis cases nationwide this year is a cause of concern. As of just this summer, almost 10,000 cases of pertussis had been reported to the Center of Disease Control in the 50 states and Washington D.C. According to the CDC, this figure represents a 24% increase compared to the same time period in 2013.

Preventing such a severe disease and death in infants are actually our highest priority. We urge all pregnant women to get vaccinated and we also urge our parents to vaccinate infants as soon as possible. For pregnant women, the current guidelines from the obstetricians are to give the pertussis vaccine at 28 to 30 weeks during their pregnancy instead of post-partum to give the baby immunity from the whooping cough. If the vaccine is not given during pregnancy, then we recommend it is given to the parents and any caregiver shortly after the child is born.

Giving the tetanus, diphtheria, and pertussis, or TDap, vaccine to pregnant women is the best way to protect infants who are too young to be vaccinated. This is actually an OBGYN guideline that is regardless of any previous TDap vaccinations. So even if you'd gotten the TDap vaccine in the year prior to you becoming pregnant, the OBGYNs still recommend that you get one during your pregnancy between 28 and 30 weeks. Unlike some other vaccine preventable diseases, vaccination nor illness from pertussis offers a lifetime immunity. This is why we need booster shots even as adults.

It is very important to vaccinate small babies because they don't even get three vaccines of the DTap. The DTap is the infant and child version of the TDap. Vaccinating people around the babies is really important because they're not going to be getting the vaccine for pertussis until they are several months old. The first pertussis vaccine is given at 2 months, the second at 4 months, the third at 6 months, the fourth at 15 months, the fifth at 4 years, and then they get the first of their adult TDaps at 11. So during that period where they are unvaccinated, it's hard to protect them if the mom has not gotten her pertussis vaccine and other adults have not gotten theirs.

The disease is spread through respiratory droplets, so coughing and sneezing are the usual methods of transmission. You can be in the waiting room or grocery store or family member's house and be exposed to pertussis. Or touch something with droplets from someone sneezing or coughing and contract the disease. Many infants are infected by older siblings, parents, or caregivers who do not even know they're infected. That's why it is so important to do what they call cocooning the child, getting everyone around the child vaccinated.

A lot of parents are worried about serious reactions to this vaccine. The truth is, serious reactions to the pertussis vaccine occurs in fewer than 1 in a million children. But between 2000 and 2012, there were 225 deaths from whooping cough in the United States and almost all of the deaths were in babies younger than 3 months old. Approximately half of the infants less than 1 year of age who got pertussis were hospitalized. It is a very low risk to take the vaccine. It's a much higher risk of a bad outcome if the child actually gets the disease. So if you're not sure if you as a parent or caregiver has had your pertussis vaccine, check with your doctor. Be sure that you're up to date on all of your adult vaccines as well to protect any children that you are caring for.

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Dr. Jones: What can you do to prevent hearing this sound in your home? That's the sound of whooping cough, the sound no mother ever wants to hear. Whooping cough is on the rise in the U.S and can be deadly to infants. This is Dr. Kirtly Jones from Obstetrics and Gynecology at University Health Care and this is the scope of the problem of pertussis known as whooping cough, on The Scope.

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Dr. Jones: Whooping cough is the familiar term for pertussis, a bacterial infection that causes a breathing problem in particular, a very particular cough. There has been a 1000% increase in the incidence of pertussis in the U.S since 1990. U.S has experienced a resurgence of pertussis and since 2010, we see about 10,000 to 50,000 cases of pertussis each year and it's reported in every state.

In 2012, we saw the most cases that we had seen in 60 years. There were 48 ,000 reported cases of pertussis and over 2000 of those were in infants younger than three months of age and 15 of those infants died. Most pertussis deaths are in infants who are too young to be protected by their own vaccine.

Pertussis can cause serious and sometimes life threatening complications in infants, especially in the first six months of life. In infants younger than a year who get pertussis about half are hospitalized. The younger the infant, the more likely treatment in the hospital will be needed. Of those infants who are hospitalized, about 67% will have breathing problems, stop breathing, 23% will get pneumonia and over 1% will die.

How do we protect our infants? We all had vaccinations when we were little and boosters later. At least we should have. However, the vaccination doesn't protect forever. The recommendation is to immunize all pregnant women between 27 and 36 weeks so the newborn can have maternal antibodies in their blood and that come through their placenta. This will help protect the infant until they are able to make their own antibodies from their own vaccine at about two months of age. Moms can also transmit the antibodies that they got from their vaccine during pregnancy through their breast milk.

Waiting until the baby is born to get the vaccine may be too late for the mom to get it in their breast milk and won't directly protect the baby as much. Moms should protect themselves with vaccinations. About 30% to 40% of infants who got whooping cough got it from their moms. But giving the antibodies to babies through the placenta and breast milk helps protect the baby from other members of the family. So moms could get vaccinations with every pregnancy. Easy, right?

Since 2011 when the Tdap vaccine recommendations were issued, vaccinations rates with Tdap among pregnant women have been low, when survey of pregnant women from 2011 to 2012 estimate that only 2.6% of women had received Tdap during their most recent pregnancy. Babies should also be cocooned. Every member of the family that's going to have contact with the baby should have a Tdap in the last five years. I have to get one just because I work in the hospital. The Tdap vaccine does not have any active bacteria, it doesn't have thimerosal, a mercury preservative that's concerned some groups, and severe side effects are very rare.

So what to do? Get your vaccine when you're pregnant. You can get the Tdap and the flu vaccine at the same time. Get the family members to update their vaccines to cocoon the baby in a pertussis-protected home. Breast feed your baby and get babies their own vaccines when they are scheduled for them. Let's not have to hear that cough. Thanks for joining us on The Scope.

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Dr. Cindy Gellner: So when is a cough just a cough or when is it something more serious, like whooping cough? I'm Dr. Cindy Gellner and that's today on The Scope.

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Dr. Cindy Gellner: So whooping cough is pertussis. Pertussis is actually a bacteria called Bordetella pertussis. It's called whooping cough because of the sound that it makes. Not all kids who have whooping cough will make the whoop sound. That is why it's so important kids get vaccinated for whooping cough in the first couple sets of shots.
Kids will get vaccinated for whooping cough at two months, four months, six months, 15 months, and then finally again at age four. The whooping cough actually makes a whoop sound where you'll hear a coughing, it's called paroxysmal coughing, and that's just a big long coughing spasm where kids will just cough and cough and cough and cough and then you hear [whoop sound] and that's exactly what it sounds like.
The whoop that goes along with the whooping cough is the one that really scares most pediatricians. Whooping cough can be deadly to babies. At six months old the immune system that they got through their mom's placenta will actually start to wean off and they have to develop their own immune system.
So that's why there's so many shots for babies until they're six months old, you get a little break at nine months old, until the 12 month old vaccines but there's so many shots until six months old so they can get protected from things like pertussis, tetanus, polio, their hepatitis B vaccine, HIB, that's Haemophilus influenzae type B, that's a bacteria that causes ear infections the pneumonia and meningitis.
But pertussis is one that really scares us because babies, if they get pertussis or whooping cough, they won't cough like that sometimes. They will just stop breathing. The younger they are, the more likely they are to just stop breathing. For older kids and the kids that you're going to hear that whoop on, pertussis, or whooping cough, it actually has three different phases. So the first one is about two weeks, you just have a persistent cold, runny nose, mild cough, pink eyes, not pink eyes as in like goopy eyes, but just injected eyes. And it will seem like a lingering cold, it just won't go away.
The second phase, that's when you hear that whoop, it's just a cough that just gets worse and worse and worse. It can last up to a month. The cough can often make the kids vomit or their face will turn red or blue and it's almost always worse at night.
If your child is old enough to have had all the whooping cough vaccines, then the good news is that they probably aren't going to get whooping cough. This vaccine is very effective.
The third phase of the whooping cough is recovery. It takes about another month for the cough to improve. The good news is whooping cough is able to be detected by a swab that we will put up a child's nose and send it off to look for this particular bacteria. If the test comes positive for that bacteria, there are antibiotics that can be given to treat whooping cough.
So the good news is, this is very treatable. It's also very contagious. Again, in going back to the babies, they can't get all the shots at once, so that's why it's really important, if you have a baby that you're around, you get a whooping cough vaccine. Pregnant women get them before they leave the hospital after they have their babies, anyone that's a daycare provider needs to be sure they have them. Grandparents need to get the whooping cough vaccine too.
Treatment of pertussis, or whooping cough, again, we do the antibiotics. The other things that can help are humidifier in the room and actually that works for any cough. Cough is your body's way of getting rid of sticky mucous that's sticking in your lungs and causing you to just get that little tickle in the back of your throat. So getting rid of thick secretions in the nose and throat can be helped with a humidifier.
Also, a bulb syringe and saline for the babies, they can't blow their noses and babies cannot breathe out of their mouth until they're about nine months old.
Other things that you can use for helping with coughing, chicken soup, anything that's warm, it's a great time of year for hot chocolate. So warm liquids will actually help with those coughing spasms too.
Honey, let's talk honey. Honey is fine for children over one year old. If they are under one year old, do not give your child honey, they cannot protect themselves from something called botulism. Botulism will cause bad things, muscle spasms, very painful to watch, very painful for the child to go through, not very easy to treat. So honey, under one, is a no no.
Other things you can do to help your child with coughing spasms, make sure that they are kept away from things, like smoke, tobacco smoke, perfumes, other pollutants in the air, that is something you're going to want your child to stay away from, so that they don't have extra inventive to cough.
How can you prevent the spread of whooping cough? Well the first thing, if a child has not been vaccinated against whooping cough, and they are old enough to be vaccinated, which is anyone over two months old, make sure you vaccinate those children, get them up to date on their vaccines.
If somebody has tested positive for that pertussis bacteria, you can give antibiotics to anyone that's been exposed to the disease. Usually the health department gets involved with this because whooping cough is a bacteria that does need to be reported to the health department.
So remember, whooping cough is a very dangerous disease, especially for babies, they don't have the immunity yet. The risk of death from whooping cough is far greater than any of the possible side effects of the shot.

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