Pertussis: The Forgotten and Deadly Disease

A new study released in the Journal Pediatrics has confirmed what many of us in public health already knew: children whose parents refuse to have them vaccinated are more likely to get and spread pertussis. Some people are likely to say so what. Is pertussis really that common or serious? The answer to both those questions is yes.

Recently, my organization was contacted by a woman named Mariah Bianchi. Mariah is a mother, a health care worker, and a San Francisco resident. In 2005, Mariah gave birth to her second child, Dylan. In her words, "He was a healthy, beautiful baby and the easiest delivery a mother could ask for."

Up to a couple weeks before and during the delivery Mariah had a low-grade fever, runny nose, and severe cough. "Our pediatrician casually mentioned pertussis and despite being a nurse, I did not know much about it.," she said. So on the day of discharge she asked her doctor and was told that pertussis, also known as whooping cough, wasn't seen anymore, that viral infections are going around this time of year and could cause the symptoms she had. "I went home hoping hand washing and breastfeeding would help protect Dylan from getting this ‘cold'," said Mariah.

When she returned from the hospital her cough continued. Within the next few weeks, she sought second and third opinions about her condition which seemed to be worsening. She was eventually tested for pertussis. At the same time Mariah noticed that her baby would fall asleep during feeding. The child's doctor wanted to get an x-ray of Dylan's lungs to make sure he didn't have pneumonia.

Less than twenty-four hours later Dylan was unable to breathe on his own, his immune system was failing, and his heart and kidneys were shutting down. Pertussis was quickly taking over his body. The very next day, after failed efforts of resuscitation, Dylan died of complications from pertussis which he had caught from his mother.

Mariah said, "I will never forget holding him in those last moments helpless powerless lifeless."

Mariah is now actively working with the Coalition and speaking out about her experience because, as she says, "I don't want to see any family suffer the way mine has."

Unfortunately, this tragic story has become a familiar one with over 40 deaths of childrendue to pertussis complications over the last decade in California alone. Across the U.S. there are similar stories including the latest one in Idaho in April.

In fact, pertussis is a lot more common than most people and even health care providers realize. Just type pertussis in an internet NEWS search and you will read about outbreaks and sometimes deaths occurring currently throughout the U.S. Pertussis is one of the only diseases that we routinely vaccinate for in which the incidence (new cases) has been on the rise over the last decade.

There may be two reasons for this increase. The first is that many people are skipping or delaying vaccination for their children. The second reason is that the immunity from the disease that many adolescents and adults received from their childhood vaccines has worn off (immunity lasts between 5 -10 years). These people serve as a large reservoir for the disease, which is frequently undiagnosed or misdiagnosed. In adults, pertussis is a seriously uncomfortable and long-lasting illness (up to 10 weeks of coughing). However, when adults spread it to young children the results can be debilitating and deadly, as Dylan's example confirms.

Children should be up to date on their immunizations to provide full protection and prevent the spread of this deadly and highly infectious disease. The risks from diseases like pertussis outweigh the risks from the vaccine.In addition, a vaccine called Tdap (Tetanus, diphtheria, acellular pertussis) is now available for people ages 10 to 64 which will boost theirimmunity and protection from pertussis. Unfortunately, this vaccine has gotten little fanfare or attention resulting in low uptake. Those who will come in contact with young children are especially urged to get a Tdap vaccination. Tdap isalso recommended as areplacement for routine tetanus vaccinations.As more people receive a Tdap the reservoir of disease in adolescents and adults should decrease and ultimately prevent the spread to very young, vulnerable children.

With some more awareness and action we can reduce the prevalence of pertussis and prevent Mariah and Dylan's story from repeating itself.