CDC Q&A: Protecting Yourself and Your Family From Whooping Cough
By Dr. James Palermo // November 19, 2015
VACCINATION IS THE KEY
ABOVE VIDEO: “The Doctors” interview a new parent and grandparent about the importance of heightening the awareness of the risk of whooping cough in infants, and the need for vaccinating family members.
Whooping cough (pertussis) is a highly contagious disease that can be especially serious—even fatal—especially for infants too young to get vaccinated. Unfortunately, it has never been eliminated in the United States, and people who spread it may not know they have it.
In recent years, there have been reported whooping cough cases and large outbreaks of this disease in different parts of the country.
The Centers for Disease Control and Prevention (CDC) recommends everyone, especially those around babies, make sure their whooping cough vaccination is up to date.
“Babies who get whooping cough often catch it from family members, including grandparents, who may not even know they have whooping cough,” said Dr. Melinda Wharton, Acting Director of the National Center for Immunization and Respiratory Diseases at the CDC.
“That’s why it’s important that parents, grandparents, and other family members get a Tdap shot to prevent getting—and spreading—whooping cough.”
This CDC “Q and A” addresses the crucial issues related to protecting yourself and your family from whooping cough:
Q: Can pertussis be prevented with vaccines?
A: Yes. Pertussis, or whooping cough, can be prevented with vaccines. Before pertussis vaccines became widely available in the 1940s, about 200,000 children got sick with it each year in the United States and about 9,000 died as a result of the infection. Now we see about 10,000 to 40,000 cases reported each year and unfortunately up to 20 deaths.
Pertussis vaccines are recommended for people of all ages. Babies and children should get 5 doses of DTaP for maximum protection. A dose is given at 2, 4 and 6 months, at 15 through 18 months, and again at 4 through 6 years. A booster dose of Tdap is given to preteens at 11 or 12 years old.
Teens or adults who didn’t get Tdap as a preteen should get one dose. Getting Tdap is especially important for pregnant women during the third trimester of each pregnancy. It’s also important that those who care for babies are up-to-date with pertussis vaccination. You can get the Tdap booster dose no matter when you got your last regular tetanus booster shot (Td). Also, you need to get Tdap even if you were vaccinated as a child or have been sick with pertussis in the past.
Learn more about preventing pertussis.
Q: Why is the focus on protecting babies from pertussis?
A: Babies are at greatest risk for getting pertussis and then having serious complications from it, including death. About half of babies younger than 1 year old who get pertussis need care in the hospital, and 1 out of 100 babies who get treatment in the hospital die.
There are two strategies to protect babies until they’re old enough to receive vaccines and build their own immunity against this disease.
First, vaccinate pregnant women with Tdap during each pregnancy, preferably between 27 through 36 weeks of pregnancy. By getting Tdap during pregnancy, mothers build antibodies that are transferred to the newborn, providing protection against pertussis in early life, before the baby can start getting DTaP vaccines at 2 months old. Tdap also helps protect mothers, making them less likely to transmit pertussis to their babies.
Second, make sure everyone around the baby is up-to-date with their pertussis vaccines. This includes parents, siblings, grandparents (including those 65 years and older), other family members, babysitters, etc.
They should be up-to-date with the age-appropriate vaccine (DTaP or Tdap) at least two weeks before coming into close contact with the baby. Unless pregnant, only one dose of Tdap is recommended in a lifetime.
These two strategies should reduce infection in babies.
It’s also critical that healthcare professionals are up-to-date with a one-time Tdap booster dose, especially those who care for babies.
Learn more about complications in babies.
Q: If I’ve had whooping cough, do I still need a pertussis booster?
A: Yes. Getting sick with pertussis or getting pertussis vaccines doesn’t provide lifelong protection, which means you can still get pertussis and pass it onto others, including babies.
Q: Do pertussis vaccines protect for a lifetime?
A: Pertussis vaccines are effective, but not perfect. They typically offer good levels of protection within the first 2 years of getting vaccinated, but then protection decreases over time. This is known as waning immunity. Similarly, natural infection may also only protect you for a few years.
In general, DTaP vaccines are 80-90% effective. Among kids who get all 5 doses of DTaP on schedule, effectiveness is very high within the year following the 5th dose – at least 9 out of 10 kids are fully protected.
There is a modest decrease in effectiveness in each following year. About 7 out of 10 kids are fully protected 5 years after getting their last dose of DTaP and the other 3 out of 10 kids are partially protected – protecting against serious disease.
Our current estimate is that in the first year after getting vaccinated with Tdap, it protects about 7 out of 10 people who receive it.
There is a decrease in effectiveness in each following year. About 3 or 4 out of 10 people are fully protected 4 years after getting Tdap.
Keeping up-to-date with recommended pertussis vaccines is the best way to protect you and your loved ones.
Learn more about protection from vaccines and infection.
Q: Do pertussis vaccines protect from serious disease?
A: If you’ve been vaccinated and get pertussis, you are less likely to have a serious infection. Typically, your cough won’t last as many days and coughing fits, whooping, and vomiting after coughing fits won’t occur as often.
When vaccinated children get pertussis, fewer have apnea (life-threatening pauses in breathing), cyanosis (blue/purplish skin coloration due to lack of oxygen), and vomiting.
Learn more about pertussis symptoms.
Q: Are most coughs pertussis and does everyone with pertussis “whoop”?
A: There are a lot of causes behind a person’s cough and not every cough is pertussis. In general, pertussis starts off with cold-like symptoms and maybe a mild cough or fever. But after 1 to 2 weeks, severe coughing can begin.
Unlike the common cold, pertussis can become a series of coughing fits that continues for weeks. The best way to know if you have pertussis is to see your doctor, who can make a diagnosis and prescribe antibiotics if needed.
The name “whooping cough” comes from the sound people make gasping for air after a pertussis coughing fit. However, not everyone with pertussis will cough and many who cough will not “whoop.”
Teens and adults, especially those who haven’t been vaccinated, may have a prolonged cough that keeps them up at night.
Those who do get the coughing fits say it’s the worst cough of their lives. And the cough may last for weeks or months, causing major disruptions to daily life and complications like broken ribs and ruptured blood vessels.
Babies may not cough at all. Instead, they may have life-threatening pauses (apnea) in breathing or struggle to breathe. Any time someone is struggling to breathe, it is important to get them to a doctor right away.
Learn more about pertussis symptoms.
Q: How contagious is pertussis?
A: Pertussis spreads easily from person to person through coughing and sneezing. A person with pertussis can infect up to 12 to 15 other people. That’s why being up-to-date with pertussis vaccines and practicing good cough and sneeze etiquette are so important.
Many babies who get pertussis are infected by older siblings, parents or caregivers who might not know they have the disease. If pertussis is circulating in the community, there’s a chance that even a fully vaccinated person of any age can catch this very contagious disease. But if you’ve been vaccinated, your infection is usually less serious.
If you or your child develops a cold that includes a very bad cough or a cough that lasts a long time, it may be pertussis. The best way to know is to contact your doctor.
Learn more about pertussis transmission.