When I first met little Pierce a few days after he came home from the Neonatal Intensive Care Unit, I noted two things: Pierce was a tough little guy, a real fighter, and his parents were two of the most caring, loving and excited first-time parents I had ever met.

So you can imagine my horror to learn that my new sweet little buddy had contracted the potentially deadly disease called whooping cough (pertussis) before he was even 7 weeks old.

Pierce was born 5 weeks early, was very small, and had respiratory distress at birth. After spending 18 days in the NICU, our little fighter was healthy enough to go home.

His parents worked really hard at getting enough calories in him daily, and I saw him in my office a lot to assure he was growing well and thriving. And he was.

A few days before Christmas, Pierce’s mom, Whitney, emailed me on our portal system to let me know he had some congestion, but seemed to be OK otherwise. Cool. No biggie! Baby’s first cold. Keep him drinking, watch for fevers, watch his breathing closely. Lots of kids have colds right now. Keep me updated.

A couple days later, he had a tiny temperature elevation to 99-100. Since he was born so early, and so small, I asked them to come in so I could check him. He looked great! So I sent them home.

Pierce’s cough was getting worse. Really junky. I checked on him again a few days later in my office. He seemed fine. We talked about what to watch for:

• A dusky color to gums and tongue.
• Chest muscles working hard to breathe.
• Not wanting to drink.
• Fever coming back.

Let me know if these things happen. I sent them home and asked them to email me updates over the next few days.

I didn’t like what I read in those updates in the next 24 hours.

“He’s starting to turn blue with this cough, Dr. Diane.”

“His cough is coming in huge fits, and it’s making him throw up.”

Pierce’s mom Whitney told me, “The moment we became super worried was when we started realizing how hard he was working to breathe. He was turning blue and dusky. He was choking. He was coughing until he would just gasp for air.”

They went to a Cook Children’s Urgent Care center that weekend, because things were getting worse. A nasal swab was done there for whooping cough, since his fits were getting so bad. The results would take a few days to come back.

But surely it wasn’t whooping cough, his parents (and I) thought! His parents had gotten their pertussis (Tdap) boosters when his mom was pregnant. And they’d asked all grandparents, aunts, uncles, and a cousin to all get their shots too. They wanted to protect their precious new baby from a known danger.

The day the whooping cough test came back positive on a Sunday, Pierce turned really blue with a coughing fit. The family went to the Cook Children’s ER immediately. I called the hospital doctor to let them know he was coming, and that I was worried about him. I sent in antibiotics for his family to take, with the hopes they wouldn’t catch it too. Pierce took antibiotics too, which made his pertussis not “spreadable,” but unfortunately this does not cure or even improve the illness once you’ve started coughing.

Whooping cough is a bacteria that we have a vaccine for. However, babies can’t get their first vaccine until they are about 2 months old. Infants are usually the hit the hardest by pertussis. They often have to be on ICU support, and 1% of infants who contract it will die.

Sweet Pierce was scheduled to get his whooping cough vaccine (Dtap) with me in my office the day after he was admitted to the hospital.

Pertussis is spread by microscopic droplets in the air. Someone coughing or sneezing near you can pass it to you. Or, just being in the same part of a room, breathing the same air, can pass the disease on to someone. It is HIGHLY contagious.

It starts with cold symptoms for 1-2 weeks. Then, the horrible coughing fits start. Adults and older kids can break ribs and pop lungs because they cough so hard. And it’s known as the “100 days cough” because it can last a long time.

Listen to Pierce’s cough in the video. You hear how he struggles to take in some breath between coughing fits? The “whoop” sound? This is how the disease got its name.

Our little hero spent a full week at Cook Children’s. He needed oxygen, fluids and supportive care. They assured he was able to drink and was breathing comfortably. They helped support him through the coughing fits and assured his oxygen levels never went too low.

“Cook Children’s was just as amazing as I knew it would be. I had heard from friends and family that the care they got there was truly the best, and we can agree with them now based on our experience,” Whitney said. “Everyone was so sweet and thoughtful. Some nurses and techs went above and beyond when they knew we were exhausted, rocking our baby so we could get some sleep. They didn’t just look after Pierce’s well-being, they looked after ours, too!”

We’re not sure how Pierce contracted whooping cough. It is such a contagious disease. It could have been at the grocery store as he napped. It could have been a well-meaning family member who hadn’t been vaccinated in a while. It could have been a bystander at the post office. Just waiting in line at a doctor’s office or sitting next to a table full of people at a restaurant can spread the disease.

Dr. Susie Whitworth, the director of the Infectious Disease clinic at Cook Children’s, told me “I wish the public understood how very safe the vaccine is, how very commonly we still see children with pertussis, and how infants still die of this vaccine-preventable disease. “

The most important thing YOU can do to protect babies like Pierce is to vaccinate yourself and those you love. The vaccine is 89% effective in children if they get all the boosters, but the effectiveness slowly wanes over time. This is why we give boosters to kids at age 4 and 11,  and why we recommend getting the vaccine at least every 10 years as an adult. So the MORE of us that get the vaccine, the LESS chance this disease can penetrate a community. And, if you’re vaccinated and do catch pertussis, several studies have shown the length and severity of illness is much less severe.

Pierce is now at home, and is feeling great. He survived a disease that so many infants do not. He came to my office a week after going home from the hospital and got his first set of vaccines. His parents told me, “We want to tell his story. We want people to understand what he’s been through. If it’s read by even one person who is on the fence about vaccines, and we change their mind, it will be so worth it.”

For More On This Topic:

• Immunization Schedule
• Calendario de vacunación
• Let's Learn ABout Whooping Cough
• Vaccines and Immunizations Information
• Pertussi (Whooping Cough)
• Is It Croup or Whoop?

I think it’s really important to know the difference – one is fairly common, and the other is much more rare – and can be deadly.

Croup is a common viral infection I see daily. It is caused by a virus, and can cause a high fever, runny nose, sore throat, and cough.

It can be scary sounding, and can show up out of nowhere. Your kiddo will SEAL BARK when they cough – it really does sound just like a seal. I can often hear it and diagnose it in the waiting room!

This virus makes the area around the voice box and the windpipe swell up. This makes them hoarse, and sometimes they have loud breathing with inhalation.

We treat it with comfort – kids often get scared of their own breathing and cough sounds, and it really makes their throat hurt – so give them ibuprofen or Tylenol, steamy showers, cool humidified air, popsicles, cold drinks. Your doc may prescribe steroids for it if they seem particularly hoarse or loud with breathing.

Most kiddos with croup do just fine at home – and they can get it more than once. However, very rarely the swelling of the windpipe is severe. If they are having a hard time breathing, seem short of breath, lethargic, won’t drink, some kids have to be seen at the hospital for support, breathing treatments, and care.

Whooping cough, or Pertussis, is a whole different beast. The word “whooping” came from the sound that babies make when they’re trying to inhale during the coughing fits of this awful bacterial infection.

Cough-cough-cough-WHOOOOOOOOP (catching breath)

Cough-cough-cough- WHOOOOOOOOP

It starts as a cold, then gets worse in a week or two. It is absolutely heartbreaking to see a baby struggle with whooping cough (watch a Youtube video of “Infant with Whooping Cough” like the one down below, courtesy of the Mayo Clinic and try not to tear up), and it can be deadly to them. They often stop breathing, and almost always must be hospitalized.

Pertussis is easily caught from others via coughed droplets in the air. Older kids and adults can catch it too, and it causes long fits of coughing – to the point of turning blue, or vomiting. Patients cough so much they commonly break ribs.

Antibiotics are given to make the person less contagious, but do not cure the illness or stop the symptoms.

The best protection from whooping cough is VACCINATION. We start this series at age 2 months, so that children are protected as young as possible.

Adults should get their pertussis booster – a.k.a. the Tdap or Tetanus shot at least every 10 years, or with every pregnancy (I and my husband both got it for both our kids).

Hope this helps clarify those confusing words we use for these special cough sounds!

More On This Topic:

• Why Children Like Olivia Need You To Immunize
• Let's Learn About Whooping Cough
• "Croupy" Cough
• 7 Facts About Whooping Cough You Should Know

If you are concerned about your child, here are seven facts you need to know:

1. Monitor your child for cough, particularly if it is occurring in severe spells or they cough so hard that they vomit. The characteristic whoop of whooping cough occurs when the child is inhaling after their cough.

2. Older children and teenagers may have severe cough but usually do not have the whoop. Infants are very susceptible to pertussis and have an increased risk of hospitalization and death.

3. Be aware that the vaccination for whooping cough is not perfect. Even if your child is vaccinated, you should be on the lookout for symptoms, particularly if you live in the Grapevine-Colleyville area or know that your child has been exposed.

4. If you are concerned your child might have whooping cough, your doctor can run a test and start treatment with an appropriate antibiotic. (Even with treatment, the cough can last several weeks.)

5. Students who are diagnosed with pertussis should remain home until they have completed five days of antibiotics or until 21 days have passed since their cough started.

6. Those who live in the house of persons diagnosed with pertussis should receive treatment to prevent the infection as soon as the infection is confirmed.

7. Other close contacts (not in the house) that should receive treatment for exposure include: those at high risk for pertussis (infants and pregnant women in the third trimester), those with health conditions that put them at more risk (severe asthma or immunodeficiency), contacts of a case that have contact with a child less than 1 year of age and contacts who work in high risk settings (NICUs, childcare and maternity wards.)

If you have further questions, please contact your pediatrician.

Related articles:

• Let's Learn About Whooping Cough
• Measles, Pertussis Increase due to 'intentionally unvaccinated'
• 3 Reasons to Still Give Your Kids Whooping Cough Vaccine
• Newborns Depend On Rest of the Family To Protect Them From Whooping Cough

“I didn’t remember it was Christmas until we left on the 26th of December," Bryan Gutierrez said. “Everything was just such a blur during our stay. I just know we were so thankful. The whole time we were at Cook Children’s, we had a feeling we were very much in angels’ hands.”

Unfortunately, their first Christmas didn’t go as Christina and Bryan hoped after their baby Quentin was born in November 2008. Within three weeks of his birth, Quentin contracted pertussis, also known as whooping cough.

Quentin experienced coughing so violent that at one point, he stopped breathing. He was rushed to a hospital in the family’s then hometown of Odessa, where the local hospital was unable to diagnose Quentin.

The coughing progressed and there was fear that Quentin's lungs would collapse. The family felt they needed more specialized care and requested a transfer to a children’s PICU.

The Gutierrez family was presented with options on where to take Quentin and decided to go with their little boy to Fort Worth.

“When we were presented with the options, I went online to research the different hospitals,” Christina said. “I found that Cook Children’s was highly rated and recommended. After looking into everything, I knew this was the place for our little boy.”

Bryan vividly recalls the Cook Children’s Teddy Bear Transport arriving in the morning to take Quentin. He said it didn’t take long to feel a sense of relief that he and his wife hadn’t felt since their son became ill.

“At the original facility, our son would turn blue. The coughing fits were getting to the point where his newborn lungs began to collapse. The doctors had failed to diagnose him or provide a treatment plan. According to the facility in Odessa, the pertussis lab test would take a couple of weeks. As soon as we walked into Cook Children's the doctors stated, "This looks like pertussis; we see this several times a year". During his first coughing fit, the nurses at Cook Children's knew exactly how to help him. We could tell we were now at a different level of care and professionalism,” Bryan said. “Within 30 minutes of our arrival, one nurse got Quentin stabilized and comforted me, all while getting us settled in. We were in the hospital for three weeks while Quentin was given the best care. The bedside manner, level of professionalism and attention to our mindset, as anxious parents, was outstanding. Our baby boy was given a clean bill of health three weeks later and we went home as extremely grateful parents.”

Quentin received care for his lungs, cleaning them out and monitoring them. The Gutierrez family would sit in on conversations between doctors and nurses during shift change. They said that transparency contributed to their confidence that they were in the right hands.

Eight years later, Quentin is a perfectly happy and healthy boy. His parents still remember their first Christmas and are thankful for who their son has become.

“When we think back to how sick he was as a baby, we are just so happy to have him in our lives,” Bryan said. “We know every parent thinks their child is special but we think he’s going to do great things someday. He’s truly a special little guy with a big heart and extremely smart. He does very well in school. He was doing an exercise at his elementary school in Flower Mound and he drew himself as president. He said the biggest thing he would do as president is be kind to everybody. I think that exemplifies what kind of child he is and proves when he was sick as a baby, it just wasn’t his time. We thank God, and Cook Children’s, for that.”

About Cook Children's PICU

The Pediatric Intensive Care Unit (PICU) at Cook Children's Medical Center cares for children with life-threatening illnesses or injuries. On-site 24 hours a day, seven days a week are two physician specialists (board certified in pediatric intensive care or board certified pediatric cardiologist) and a nurse practitioner trained in pediatric intensive care. Specialty physicians, such as neurologists, pulmonologists, oncologists and cardiologists, are available for consultation or referrals. Click to learn more.

Just in time for the holidays a reader wrote in with this question:

“My friend...was told by her grandson’s pediatrician that her grandchildren who are vaccinated should never be around any unvaccinated children. Well, the parents of her other grandchildren do not want to vaccinate their small children…As a result there are no more family gathering with all grandchildren. They have to spend holidays on separate days. My question is: Why would the pediatrician say this? If the children who are vaccinated and the children are not showing symptoms what’s the problem?”

This is definitely a sad and tricky situation and one that we should use extreme care when discussing.

One thing I will say is that no matter what one’s choice about vaccinating is, parents believe they are making the choice in the best interest of their child. Of course, I have strong opinions about how important it is, but this discussion is not for the faint of heart.

There are probably some doctors that would tell you it’s no big deal and you shouldn’t worry about it (I would disagree with them). There are other doctors that would say you should never have your child around children who are unvaccinated regardless of your child’s health (I recognize this is not reasonable in many situations).

Here are the questions to consider:

1. How old is the child? The younger the child, the more vulnerable they will be to infection. They cannot receive protection for chicken pox or measles before 1 year. Older children who are fully vaccinated have a significant amount of protection and they likely encounter an unvaccinated child at school every day.
2. Who isn’t vaccinated? This question is about family members which makes transmission of infectious diseases more likely than if you just walked by someone on the street and were not interacting with for longer periods of time.
3. Can you have an open conversation with those involved? The discussion is clearly more complicated than simple medical advice as it broaches on several tricky areas including family dynamics and vaccination.

The easy (get out of having to make a committed answer) is that there is no one answer to the question. The family should talk with their doctor about their specific concerns and make a decision with their counsel.

Should I stop the blog post there? Not so fast.

Instead, I want to give you a framework for having that discussion with your doctor.

What diseases should I be worried about?

I believe that all vaccines are important, period. But there are 3 diseases that jump to the top of my list when considering this issue:

1. Flu

Flu season is predictable in that it comes every single year at roughly the same time. It is unpredictable in that we never know how widespread it will be and how severe the cases will be when it does come around. Flu is particularly dangerous in babies and they cannot be vaccinated until they are 6 months old. Remember that the flu vaccine isn’t perfect, so I’m not saying that everything’s cool if we all have flu vaccines but it would seem logical to get as much protection surrounding the baby as possible.

2. Pertussis

Pertussis, or whooping cough, is still common and is a very serious disease for anyone who gets it. In children, teenagers and adults it tends to cause a very rough and painful cough that lasts for weeks to months. I know of adults who have had broken ribs because the coughing is so hard. The real danger for pertussis comes in small babies (less than 3-4 months). These babies commonly have spells of coughing that cause them to stop breathing; leading to ICU stays for intubation and unfortunately, death. Babies are vaccinated against pertussis at 2, 4 and 6 months which increases the number of children who are protected with each shot but they go on to get another vaccine at 4 and 11 years as well. So, when are they fully protected? It’s impossible to say. In addition, vaccines are not perfect so even vaccinated infants who are exposed could develop pertussis. Pertussis still occurs commonly in the United States and is generally carried by older children and adults who are coughing but do not know that they have pertussis. Just like flu, having the vaccine does not prevent disease 100% and I still feel that we need to do something better with the pertussis vaccine but again, it would seem logical to increase protection as much as possible.

3. Measles

Measles is another disease that still occurs in the United States. In 2014, there was a record number of 667 confirmed measles cases reported to the Center for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases (NCIRD). That’s the highest number of cases since measles elimination was documented in the U.S. in 2000. Measles can cause pneumonia and have a higher risk of hospitalization in children under 5. Children receive their first measles vaccine at 1 year of age, but they have no protection from measles until then.

What criteria should I use for being around others?

1. If your baby is under 6 months, use extreme caution. Many babies do not have full protection until after the 6 months shots. In addition, they cannot receive a flu vaccine until 6 months.
2. If your baby is under 1 year, I would also use caution. Your baby cannot be vaccinated against measles or chicken pox until 1 year.
3. After your child is vaccinated at 4 years, they have much of the protection that they need to protect themselves against the vaccine preventable diseases.
4. Babies or children who may not have a normal immune system-such as those with chronic illness or who were born premature deserve extra caution.
5. Anyone with symptoms of illness, especially fever, cough, congestion or rash, should not be around your baby or child regardless of your contacts’ vaccination status.

Can you get a definitive answer about when your baby can be around unvaccinated children? No, but you at least have some information to make an informed decision.

After you’ve discussed your plan with your pediatrician how do you handle the conversation with friends and family?

Here are some thoughts about some things you might say:

1. Our baby/child doesn’t have protection against many very dangerous diseases and we do not feel comfortable having her around people who could spread them to her.
2. Our baby/child has already been through so much, we can’t risk putting her through another medical problem. Especially something that we could have avoided.​
3. The doctor was emphatic that we cannot be out around anyone (especially someone who is not vaccinated or you could leave that out) until __________. (I’m fine with a family placing the “blame” completely on me.)

This was a common sound heard on the inpatient floor this past year as I worked as a hospitalist. Young babies coughing until they couldn’t catch their breath followed by our respiratory monitors alarming for low oxygen saturations and low heart rate. Unfortunately, it was so common I could diagnose the problem from the hallway. If you watch the news often you’ve probably guessed the diagnosis.

Pertussis. Also commonly referred to as whooping cough or, ”the 100 day cough”.

Tarrant County has seen many cases of whooping cough in the past several years:

• 2013 - 700 cases
• 2014 - 467 cases
• 2015 - 308 cases

Recently there was a case in the news media about an infant death from pertussis; unfortunately this happens to between 0.5-1 percent of children under a year who contract this illness.

Pertussis is primarily a respiratory infection caused by the bacteria Bordetella pertussis. It is very contagious! It is a tricky diagnosis to make because the initial 1-2 weeks of infection seem like a cold. Patients have a clear runny nose, sore throat, watery eyes with mild cough and may not even run a fever. These symptoms are usually treated symptomatically at home. When they fail to resolve and become more severe with the characteristic coughing spells they come to medical attention.

To diagnose pertussis a nasal/throat swab (similar to a flu test) has to be obtained. Unfortunately, the diagnosis usually isn’t made until this second phase of illness and treating with antibiotics at this point doesn’t do much to alter the course of the infection. The cough is frequently followed by a “whooping sound” as the patient struggles to catch their breath. Infants don’t tend to make this sound as often as older children. It is common to vomit after these long coughing episodes and this phase of illness lasts for at least a month. A month!

In younger babies (less than 4 months) it is common for them to cough until they are blue and to stop breathing (apnea) and to not be able to maintain adequate hydration or weight gain. Young infants with pertussis frequently require hospitalization. While working as a hospitalist, it was not uncommon for a baby to be in the hospital for a few weeks while we gave them intravenous fluids to keep them hydrated, fed them through a nasal feeding tube and supported them during coughing fits.

Unfortunately, this infection can be fatal and frequently babies do require mechanical ventilation (breathing machine) in the intensive care unit. Less commonly, the infection can cause brain swelling (encephalopathy) and cause seizures.

Pertussis is spread through respiratory droplets. Babies, who are at highest risk of severe complications and too young for vaccination, usually catch the infection from an adult who is undiagnosed. Patients are contagious for a long time, up to several weeks. Often, it is an older family member with a cough for several weeks duration. It is devastating to families when they realize they were unknowingly the source of the infection that has caused the baby to be hospitalized.

All pregnant women are now encouraged to receive a pertussis vaccine in the third trimester of their pregnancy along with the other adults that will be living in the home. Having this “cocoon” of protection helps protect vulnerable infants until they are old enough to receive the immunization themselves.

We have said this before (many times), but a new study shows just how true this statement is.

A recent study published in the Journal of the American Medical Association (JAMA) looked at the combined data of 18 published measles studies on several measles and pertussis outbreaks.

Reviewing a total of 1,416 measles cases, 56 percent had no history of measles vaccination. This is way higher than you might expect given that most still choose to have their child vaccinated.

Still the study states that “a substantial proportion of the US measles cases in the era after elimination were intentionally unvaccinated.”

Intentionally unvaccinated?

As a pediatrician this concerns me. As a dad, it terrifies me.

In one outbreak the risk of contracting measles was 35 times more likely when parents had skipped the shots. A child who isn’t vaccinated is much more likely to spread measles than a vaccinated child.

We know that the pertussis vaccine is not working as well as we would like. The protection from the vaccine is falling off quickly. However, this study showed that despite this, vaccine exemptions continue to be a factor in the spread of pertussis outbreaks. Somewhere around 1 out of 3 kids who got pertussis during these outbreaks was unvaccinated.

Why are children not getting the vaccines? Not all studies had the information necessary to say. But, for those that did, most families skipped the vaccines for personal or religious reasons (70 percent for measles, 60-90 percent for pertussis).

This is further proof to something we’ve suspected for some time. Having even small pockets of unvaccinated children increases the risk to the whole community.

Each of these families who chose not to vaccinate gamble on 3 issues:

1.Their child would not be exposed to the disease (banking on herd immunity whether they know it or not).

2.If their child was exposed, that they would not contract the disease.

3.If their child contracted the disease, they would not suffer serious consequences.

These are consequences I’m not willing to gamble on.

In the case of measles, consequences could mean pneumonia, hospitalization and, later in life, neurologic complications.

In the case of pertussis, consequences could mean painful coughing, broken ribs and, in the very young, death.

This is further proof to something we’ve suspected for some time. Having even small pockets of unvaccinated children increases the risk to the whole community.

Aside from flu, I can’t think of any other disease for which we vaccinate where we are excited if only a few outbreaks happen here and there. Yet, despite relatively high vaccination rates at recommended times, we continued to see outbreaks of pertussis occur across the country.

A recent study, published early online for Pediatrics showed that the effectiveness of the new vaccine might even be worse than I thought. The study looked at the medical records of children diagnosed with pertussis. They looked to see if they had the newer, acellular vaccine as children and how long it had been since they received their Tdap (Tetanus, diphtheria and pertusiss) booster. This booster is usually given at age 11.

The most striking statements in the article is how quickly immunity from the vaccine decreases over just a few years after receiving the Tdap booster. The first year yields about 69 percent effectiveness. The second through fourth years decrease like this: 57 percent, 25 percent and 9 percent. We only give boosters for Tdap every 10 years.

The effectiveness was so bad that the authors concluded the study by saying: “We expect future pertussis epidemics to be larger as the cohort that has only received acellular pertussis vaccines ages. The results in this study raise serious questions regarding the benefits of routinely administering a single dose of Tdap to every adolescent aged 11 or 12 years.”

Will I stop giving pertussis vaccines to my 11 year olds? Would I skip it for my kids?

The answer to both of these questions, for now, is “No.”

Here are 3 reasons why:

1.There are very smart members of a group called the Advisory Committee on Immunization Practices (ACIP) that review vaccines and make new recommendations every year. These folks understand vaccines and the statistics surrounding their effectiveness better than anyone else in the country. They are not afraid to make changes that are based on very minute details (like whether you can be vaccinated with different brands of vaccines over time and they still work). There is no question they will review this study.

2.We have another disease for which we continue to vaccinate even though the vaccine strategy isn’t perfect and we continue to prevent thousands of severe cases and death from flu every year. Do we continue to look for better strategies and products for vaccination for both flu and pertussis? Yes. Do we throw out what we have because it isn’t perfect? No.

3.Even if the vaccine effectiveness wanes quickly, that one year of protection could be important for specific populations. Pregnant moms not only need to be protected from contracting the disease, they pass antibodies to their babies if the vaccine is given at the right time during pregnancy. Because of this, it is now recommended that pregnant moms receive the vaccine with each pregnancy. Perhaps we should consider giving a booster shot to all close contacts with the baby no matter when their last booster was given.

Reading this study and the subsequent articles I saw was disheartening. I have seen babies struggling to breathe and subsequently die from pertussis. It’s awful.

Undoubtedly, we need a better vaccine and strategy. For now, I’ll continue to do the best I can until we have something better.

However, some moms and dads may not realize the harm they are doing their newborn by not getting themselves or their older children vaccinated for whooping cough, or pertussis.

Because the immunity of a newborn isn’t fully developed, babies are at high risk for contracting potentially fatal illness and disease.

A new study published in the journal Pediatrics stresses the importance of the entire family getting vaccinated, at least those old enough to receive the immunization. The study says babies who contracted whooping cough were now more likely to get the infection from a sibling than a parent.

The study states that pertussis “is poorly controlled” and that the incidence of pertussis in this country is on the rise.

In contrast to previous studies, data now shows that infants are contracting whooping cough more often from their siblings than from their mothers. Doctors suggest that this may be because of vaccine effectiveness wearing off over time in these older children. They then contract pertussis more easily and the younger siblings (including infants) are more likely to be exposed.

Five vaccine doses are recommended by age 6, with a booster shot at age 11 or 12. Booster shots also are recommended for adults.

Infants are at greatest risk for disease and death from whooping cough, especially during the first 2 months of life before pertussis immunizations begin. That means that everyone in the family should be vaccinated when a newborn is being brought into the family.

While the parents, adolescents and caregivers who will have direct contact with the baby should all be up-to-date on their immunizations, the two most important vaccinations for adults to receive are influenza and combination booster for tetanus, diphtheria and pertussis (Tdap).

“Tdap is recommended for all pregnant women during each pregnancy to prevent the baby from getting pertussis if coughed on in the first few months of life before the baby has time to get immunized,” said Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children’s. “The mother makes antibodies that go into the baby’s bloodstream during the pregnancy. Those last until the baby gets his or her 2-month shots.

“It’s very important for everyone in the family, including parents, siblings and grandparents to have the vaccine. Pertussis can be deadly if a child contracts the disease in the first 3-4 months of life.”

About the source

Mary Suzanne Whitworth, M.D. is the medical director of Infectious Diseases at Cook Children’s, which offers care for children and teens with diseases caused by bacteria, parasites, fungi or viruses. Our team provides a broad range of services including diagnosis, inpatient and outpatient consultations, immune deficiency evaluations and treatment of recurring infections.

Now I know that the reason that no one got whooping cough when I was younger was due to a vaccine that I received called DTP. We now give a slightly different version of the vaccine called DTaP. Children are supposed to received DTaP at 2, 4, 6, 12-18 months, and 4 years of age. They then get a booster dose of a related vaccine called TDaP at 11 and a second TDaP booster in adulthood (recently added to the recommendations).

Whooping cough, which is also known as pertussis, has been on the rise all over the country for several years now. I see it in our clinic in Mansfield and throughout the area. There are various theories as to why it is coming back. Some theories center around the idea that people’s immunity toward pertussis wears off as they get older. Others deal with the issue of people who do not vaccinate themselves or their children. Still more center on possible mutations in the illness itself. Whatever the cause, what we do know is that it is here and causing problems.

Whooping cough can be very dangerous for children, especially if they are under age 1, but many parents don’t realize that their children have it until they have been sick for at least a couple of weeks. At the beginning, it can look like a simple cold. The typical story is that the child has been sick for 2 weeks or more and is having “coughing spasms” that can cause them to “lose their breath,” vomit, or even pass out. Regular cough medicine hasn’t helped (not to mention it isn’t recommended in children). Parents have typically tried all of the regular tricks like honey, humidifiers, vapor rubs, etc.

Under age 1, however, children don’t necessarily cough. Instead of coughing, infants may simply not breathe, which is called apnea. Since that is a very dangerous and silent problem that can kill, we must do our best to protect infants from even catching pertussis – which is where vaccination comes back into play. All people in the same household as an infant, including adults, should have a current pertussis vaccination.

Unfortunately, pertussis doesn’t have a simple, quick test like strep or flu does. In our office in Mansfield, we do have a test that we can take the sample in the office, though, which isn’t typical of many clinics. The result from the test is usually available in about 3 days. Pertussis can be treated with an antibiotic, but only if it is caught early. Once past the early phase, a person must simply recover from it, and that can take up to 3 months, even if there are no complications from the infection.

Vaccination is not a 100 percent guarantee that children will not get the whooping cough, however, it has been shown to greatly reduce their chances of getting it, and if they do get it, their case will likely be less severe than if they were not vaccinated. There are also children who cannot receive the DTaP vaccine for various reasons, some of whom have serious health problems. We all need to do the best we can to protect ourselves and our neighbors from this disease, which is making quite the comeback in our community.

The

I understand the fear. Ebola is a terrifying disease. Symptoms start off similar to flu and progress to liver and kidney failure, followed by internal and external bleeding and then often times by death (about 60 percent of the cases).

So, I get it, it’s scary. The way people die from Ebola is very unpleasant which makes it even scarier. But it shouldn’t be the scariest infectious disease to us. Here are three reasons why:

Reason No. 1 – It’s actually not that contagious.

Ebola is transmitted via blood and body fluids. Contrast that with measles and flu, which are spread via droplets. Obviously, doctors are using extreme caution when treating patients with Ebola and I agree with that. However, the likelihood of catching Ebola from being in the same room with a person with it is not that high. If someone with measles or flu coughs or sneezes near you, it’s very possible that you will contract the disease.

Hepatitis A is another virus that can spread quickly because it is spread via a pathway called the fecal-oral route (yes, it’s as gross as it sounds). It causes vomiting and in severe cases, liver failure. Outbreaks of Hepatitis A often occur when a food worker unknowingly spreads the disease by handling the food with contaminated hands.

Meningococcal meningitis is another illness that commonly spreads quickly and anyone who has been in the room with an infected person is at risk. Outbreaks used to occur commonly on college campuses prior to the introduction of universal vaccination. Health care workers who are exposed to a patient with meningitis have to undergo treatment to try to prevent contracting the disease. So remember that when the person next to you in a room looks sick; it’s probably not Ebola, but it could be any of these other scary things.

Reason No. 2 - People with Ebola are not contagious until the affected person is sick.

Because patients with Ebola are very sick, they are unlikely to be walking around infecting everyone in their path. There will not be people walking around looking fine, unknowingly spreading the disease to everyone they meet. This is not the case for many other infections. See my example for Hepatitis A above.

Pertussis, or whooping cough, is another disease where many infected people (usually adults) can walk around contagious for weeks at a time coughing the bacteria on everyone they meet. Pertussis is not that serious in adults (aside from an occasional broken rib here and there), but it can be deadly in small babies. Despite being sick, many people with flu suck it up and trudge into work or school because they think flu isn’t that big of a deal. The problem is that while one person may not have trouble with flu, they may have contact with small infants, pregnant women or older adults who can have significant complications from it.

Another disease that affects 1/3 of sexually active teenagers and adults is human papilloma virus (HPV). Most often boys and girls who carry HPV do not know they are infected and thus spread it to their sexual partners. HPV by itself is a troubling problem, but even more troubling is the fact that HPV is the leading cause of cervical cancer (about 99.7 percent of cases).

Reason No. 3 - Ebola is not that common and has not been transmitted in the United States.

The world-wide, all-time death total from Ebola sits in the thousands … the world-wide death toll from measles was 122,000 in 2012 alone. Ebola has a very high rate of death and severe illness, much more so than measles, but because measles is much more common it affects many, many more people. There has never been a case of Ebola transmitted from person to person in the United States. There have been over 600 cases of measles in the United States thus far in 2014. What about deaths? Fortunately, there were no deaths from measles, but in 2012 there were 52 deaths from the flu just in pediatric patients. It’s a simple reminder that we sometimes forget how dangerous things are when we have not heard about them for a while.

Now what?

If you aren’t convinced that many of these other infectious diseases are a more immediate concern for you than Ebola, I understand. When things are new and sound scary they tend to take over your mind. But after reading all the points I’ve made above, know there is something you can do to protect your child from the other diseases I’ve mentioned …

Every single bolded disease has a vaccine! While vaccines are not perfect and getting a vaccine in some cases does not protect you 100 percent, they significantly decrease your chances of contracting any of these diseases. In many cases, if vaccines don’t completely prevent the disease, they make the case milder and less serious. If you agree with my concerns about these other diseases, give your child the best chance by having them vaccinated.

I hope I’ve addressed all of your questions or concerns. Maybe, you still have questions about the diseases mentioned here or the vaccines to fight them? If so, please talk to your pediatrician.