Don’t let pertussis make a comeback

Dr. Jane Siegel is medical director of Infections Prevention and Control at Children’s. She’s also a professor of Pediatrics at UT Southwestern, the Chair of the Advisory Panel for Healthcare – Associated Infections and Preventable Adverse Events for the State of Texas and a member of the Committee on Immunizations and Infectious Disease for the Texas Pediatric Society. In honor of National Infant Immunization Week, she wrote this blog on why it’s important for everyone to be vaccinated against pertussis and other diseases.

Dr. Jane Siegel

Dr. Jane Siegel

Did you know that it’s National Infant Immunization Week? Probably not, I’m guessing. For many of you, having your children immunized is a routine assignment that you don’t think much about.

If you immunize your children, I applaud you. But did you know that immunization rates are down worldwide, including in the United States? And because of this, diseases once eradicated — like pertussis (whooping cough) and measles — have made a comeback?

It’s ironic that, as we are celebrating immunization achievements this week here at Children’s, we have cared for six patients with pertussis already in April. Four of those children are newborns between 4 and 5 weeks of age, and three of them required lengthy stays in the intensive care unit. One of the patients sadly did not survive. I help care for these children, and it’s heartbreaking to see these babies so critically ill with a preventable disease.

After the introduction of pertussis vaccine in the 1940s, there was a dramatic reduction in the 176,000 cases per year in the U.S. that had been reported . But we have seen the number of cases slowly creeping up each year since the 1980s because of “waning immunity” in adults and adolescents. More than 27,000 cases were reported in the U.S. in 2010. It’s common these days to hear about outbreaks occurring in different states across the country, mainly due to lack of immunization. Recent examples include California and Washington.

Dallas County, however, has seen continued reduction in the annual number of cases reported since the introduction of the adolescent/adult pertussis vaccine in 2007. The number of cases of pertussis reported from Children’s has decreased from 221 cases in 2008 to only 13 in 2011. This is remarkable, and we want to keep it that way. We think that the current cluster will remain small because so many people have been immunized.

Why do we want to prevent pertussis?

1. Pertussis kills. Young infants in the first few months of life and who have not yet received all of their vaccines are the most vulnerable. These babies are literally “gasping for air,”have difficulty coughing up the thick secretions that are formed and are prone to develop pneumonia and convulsions. No matter how much support is provided, some very young babies with pertussis will die.

2. Pertussis feels very bad for a long time. I have a good friend and colleague who developed pertussis as an adult before the adult pertussis vaccine, Tdap, was available. She described the agony of the frequent attacks of severe coughing that lasted for several months, the pain in the ribs from coughing, and the lack of sleep. This illness disrupted her life completely.

3. As adults, we can infect other vulnerable infants and children even though we have what seems like a mild cough. Some adults may not have a very severe cough because they have a “partial immunity,” but can spread the germ to young infants or people with weakened immune systems who can develop severe disease that may be fatal.

All this can be prevented by immunization!

Immunization RecordImmunizations are one of the top 10 public health achievements of the 20th century.

National Infant Immunization Week (NIIW) is an annual observance to promote the benefits of immunizations and to improve the health of children 2 years old or younger. Since 1994, local and state health departments, national immunization partners, health care professionals, community leaders from across the United States, and the Centers for Disease Control and Prevention (CDC) have worked together through NIIW to highlight the positive impact of vaccination on the lives of infants and children, and to call attention to immunization achievements.

A recent study, based on annual birth rates in the United States, indicates that vaccinating every child born in a given year, prevents approximately 42,000 deaths and 20 million cases of disease over the lifetime of those children.

Here are 5 reasons why we should provide all the recommended vaccines to our children and to adults:

1. Immunizations can save your child’s life. Just ask your grandparents what it was like to live in an era when the threat of polio returned every summer or when children died from bacterial meningitis.
2. Immunization protects others you care about. Very vulnerable babies who are too young to be vaccinated, the elderly or those with weakened immune systems who may not respond to vaccines can be protected by having all those around them receive vaccines and decrease exposure to serious infections.
3. Immunizations can save your family time and money.
4. Immunizations will protect future generations.
5. Vaccines have a great track record for being safe and effective. Those who develop, manufacture and administer vaccines are just as interested in assuring the safety as are those whose children are receiving the vaccines. Monitoring for safety is ongoing for all vaccines.

Want to learn more? Check out the website for the National Network for Immunization Information: www.immunizationinfo.org/ or send us your questions.

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