Whooping cough. The name is downright Victorian — like "cow pox," "the grippe" and other old-fashioned afflictions that have been wiped out by modern vaccines. But this bacterial infection is making a dangerous comeback.
Last week, a fourth suburban Philadelphia school district confirmed an outbreak of whooping cough, also known as pertussis. As of Friday, there were eight confirmed cases in the Quakertown School District, two at Hillsdale Elementary School in the West Chester Area School District, two at Great Valley High School in Malvern, and one at Saucon Valley High School in Hellertown.
Pertussis "starts with mild cold symptoms like a runny nose and mild cough," says Kristen Feemster, MD, MPH, MSHP, of the Children's Hospital of Philadelphia. Then come episodes of rapid-fire coughing. "The episodes can be so severe that the lungs run out of air, resulting in a forced inhalation that sounds like a 'whoop,' " she says.
Whooping cough's real danger is to babies younger than six months old who have not yet been fully vaccinated. (Infants should receive a vaccine against pertussis at 2, 4 and 6 months, according to the CDC.) "It is estimated that one-fourth of infants younger than 6 months old [with pertussis] develop complications like pneumonia or seizures and 1 percent of infants younger than 2 months old with pertussis may die," Feemster says. "The Philadelphia Department of Health released a health alert in January indicating an increase in the number of reported pertussis cases, including one that resulted in an infant death."
CHOP usually sees one to two cases a month, she says, but has diagnosed 14 in the last two months. And pertussis has been on the rise across Pennsylvania and the nation in recent years.
Why are older kids coming down with pertussis — and passing it around? It turns out that the whooping-cough vaccine isn't 100 percent effective, and immunity wanes with time, Feemster says. That means older kids and adults who've been vaccinated can still pick it up. And passing this infection along couldn't be easier. Pertussis is highly contagious. An unvaccinated person has a 90 percent chance of catching it from an infected family member and a 50 percent to 80 percent chance of picking it up if it's going around at school or daycare. That's why kids with pertussis and their families receive antibiotics to shut down transmission. And why new mothers and their immediate families are sometimes given pertussis vaccine booster shots to "cocoon" infants.
Now, there's a better way to protect little babies. In late January, an advisory panel for the CDC recommended pregnant women get a pertussis vaccine booster shot after their 20th week of pregnancy. It's a "two-fer," protecting moms and passing antibodies along to their babies in the womb, for earlier protection in the first months of life.