Feb 2, 2015

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.

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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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