Whooping cough and the TdaP vaccine

December 11, 2011 Hema Nirmal, MD, FAAP

There has been a recent outbreak of pertussis, a disease also commonly known as whooping cough, around the country. In the state of WA there have been 58 infants less than 1 year of age diagnosed with whooping cough; among these cases, 22 were hospitalized and 2 have died.

What is pertussis?

Pertussis is a highly contagious disease that is particularly severe in infants. . It is an infection of the airways caused by bacteria. More than half of infants younger than 1 year of age who get the disease must be hospitalized

In infants and children, the disease usually begins with runny nose, low grade fever, and mild cough that last for about 7-10 days. The cough usually worsens and infants may develop bursts of numerous rapid coughs. These bursts of cough are accompanied by sweating, facial flushing, and sometimes vomiting. With this disease, about 1 in 5 infants may develop pneumonia, about 1 in 100 will have seizures, and in rare cases whooping cough can lead to death.

Adults and adolescents also acquire this infection but do not have as a prolonged course as infants.
They usually have a prolonged, persistent cough that is often confused with acute bronchitis.

Whooping cough is most contagious before the coughing starts. Vaccinations are the best way to prevent the disease. 2 vaccines are available – the childhood vaccine is called DTaP vaccine and the booster vaccine for adolescent and adults is called the TdaP vaccine. Although both these vaccines protect against Pertussis, tetanus and diphtheria, the immune response can fade with time.

It is important as parents and caregivers that we are all immunized in order to prevent the spread of the disease to infants and children, who are most vulnerable. The vaccine recommendations are as follows:

  1. All children must receive 5 doses of the DTaP vaccine- three doses by 6 months of age with the first dose administered between 6-8 weeks after birth, fourth dose between 12-15 months of age and the fifth dose by 4-5 years of age.
  2. If a 7-10 year old is not up-to-date with DTaP vaccines, a dose of Tdap should be given before the 11-12 year old checkup.
  3. Tdap booster for adolescents at 11 years of age
  4. Tdap booster for adults who have not received the vaccine
  5. Administering Tdap during pregnancy in the 3rd trimester or late 2nd trimester ( preferably after 20 weeks)
  6. Administering Tdap to adults and adolescents 2 weeks before close contact with an infant.

You can get additional information from your physician regarding immunization against whooping cough. The Washington State Department of Health and the CDC have some useful information if you want to learn more about pertussis.


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