Vail Daily health story: Gasping for air
July 30, 2013
Whooping cough (pertussis) by the numbers:
Who should be immunized?
Five doses for children: at 2 months, 4 months and 6 months, another between 15 and 18 months and a final dose between 4 and 6 years.
Women in the 25th to 37th week of pregnancy.
Adults 65 years and older.
Anyone who lives with or spends time with infants.
Whooping cough statistics:
• National incidences in 2012: 13.4 per 100,000 people.
• Incidences in Colorado last year: 28.9 per 100,000 people.
• From 1922 to 1950s: 100,000 to 250,000 cases reported per year in the U.S.
• From 1960s to 1990s: only a few thousand cases reported per year in the U.S.
• 2000s to present: 10,000 to 25,000 cases reported in the U.S.
• 159 U.S. deaths between 2004 and 2007, 141 of them infants younger than 3 months.
• 41,000 U.S. cases reported in 2012 and 18 deaths.
• 1,510 cases reported in Colorado in 2012 compared to an average of 158 each year from 2007 to 2011.
• Aug. 2012: Whooping cough declared an epidemic in Colorado.
Anyone who has had such a bad coughing fit that they end up gasping for air has an inkling of how serious whooping cough can be. While it may sound like an exotic or outdated disease to some, it's actually on the rise — particularly in Colorado. This is why the physicians and staff at Vail Valley Medical Center strongly recommend routine immunizations.
Whooping cough, or pertussis as it is referenced in medical fields, produces symptoms typical of the common head cold in adults: runny or stuffy nose, sneezing and cough. After a week or two, the disease more clearly presents itself as a very severe cough that makes breathing, eating, drinking and sleeping exceedingly difficult and can cause severe respiratory problems especially for infants and young children. If they are infected, they can turn blue or vomit due to lack of oxygen. While whooping cough can be treated with antibiotics, it can be potentially fatal for infants, especially those in the first few months of life.
"This is not a little bit of a cold in a baby. This kills a lot of kids," said Dr. Jeffrey Brown, pediatric hospitalist at Vail Valley Medical Center. "It is not something infants get over like they can a cold. There are very significant consequences."
The name whooping cough was derived from the "whoop" sound individuals make following a coughing fit when they are gasping for air. The reason the disease is so much more of a concern for infants is because the airways in their lungs are so small and underdeveloped. Thus, all babies should receive a dose of the vaccine DTaP — which combines the vaccines for whooping cough as well as Diptheria and Tetanus — at 2 months of age, 4 months, 6 months and between 15 and 18 months. Children should then receive another dose between the ages of 4 and 6 years.
"What happens in infants is they can suffocate," Brown said. "Pertussis causes a mucus that is like model glue and it affects the trachea and other airways in the lung. They're trying so hard to breathe through airwaves the size of pencils that their hearts give out."
Vaccine 'really, really helps'
There were 1,510 cases of whooping cough reported in Colorado last year, compared to an average of 158 cases each year between 2007 and 2011. The increase is described as an epidemic. There were over 40,000 cases of pertussis identified nationally in 2012.
"It used to be really common for people to get it in the '60s. There were a lot of reports of hospitalizations. With the advent of a vaccine, cases have dropped off substantially. It stayed down through the 90s, then in the early part of the 2000s. We started to see a substantial increase," said Mike Brown of Vail Valley Medical Center Infection Control. "Because of a decrease in the use of the vaccine across the United States, you see a corresponding rise."
Between 2004 and 2011, there were 159 deaths resulting from whooping cough, 141 of them infants younger than 3 months. Still, infants are not the only people who should be protected from the disease.
"The vaccine is also recommended for pregnant women in their 27th to 35th week of pregnancy — for every pregnancy — and all adults 65 and older," said Stu Read, Vail Valley Medical Center's director of pharmacy. "It's also highly recommended for people who live with or take care of infants."
Although the vaccine does not guarantee 100 percent protection from whooping cough, it certainly provides a significant barrier.
"Overall the vaccine is effective about 70 percent of the time. Among children it is about 85 percent effective, but for children who receive all recommended doses it is over 90 percent effective," Mike Brown said. "It's never 100 percent. That's why it's so important to get everybody in the categories who needs to be vaccinated. It really, really helps."
As with any vaccine, certain parents and individuals find it unnatural and unappealing to inject bacteria and chemicals into their bodies. But according to statistics, before the DTaP vaccine, whooping cough accounted for about 8,000 deaths per year in the U.S. If not immunized, nearly everyone exposed to the disease will get sick.
"The best thing folks can do to prevent it is make sure their kids are adequately immunized," Dr. Jeffrey Brown said. "For families who don't want to get vaccinated, I encourage them to come to the bedside of an infant with pertussis to see what a devastating illness it can be. The reality is that more than half of infants who get pertussis are hospitalized. If enough people don't immunize, the pool of susceptible kids goes way up. Not only are they putting their kids at risk, they're putting the entire community at a risk."
Walk-in vaccinations are available during regular business hours at both the Eagle Valley Pharmacy located in the Vail Valley Medical Center and the Edwards Medical Center Pharmacy at Shaw Regional Cancer Center. For more information or hours of operation, visit http://www.vvmc.com/pharmacy or call 970-479-7253.
Shauna Farnell is a freelance writer contracted by the Vail Valley Medical Center. Email comments about this story to firstname.lastname@example.org.