Dec 11, 2014

TRANSCRIPT

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.

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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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