Monthly Archives: March 2010

Whooping Cough–Pertussis & Tdap

Whooping cough, also known as pertussis, is a highly contagious respiratory tract infection. Although initially it resembles a simple cold, whooping cough may eventually become more serious especially in children and infants as it can lead to hospitalizations, dehydration, pneumonia etc. A typical course of this infection is that you have slight cold-like symptoms of runny nose, post nasal drip in the back of the throat, scratchy throat and just feeling a little under the weather but then it progresses into a dry or productive hacking cough that just doesn’t get better and can progressively get worse. Often times the coughing is so severe that it can cause “post-tussive emesis”–which means that you cough so much that you start vomiting. Unfortunately, Whooping cough is most contagious BEFORE the coughing even starts. The best way to prevent it is through vaccinations. The childhood vaccine is called DTaP which contains immunity against three different infections including Diphtheria, Tetanus and Pertussis (whopping cough); adolescent and adult vaccine is called Tdap (which also protects against the same three infections). Children usually get up to 5 doses of the DTaP combination vaccine from birth to 6 years of age and get a booster between 12 and 13 years of age with the Tdap.

As you can see majority of us have had this vaccine as children but we thought that we had lifelong immunity to the Pertussis (whooping cough) part of the vaccine so we dropped it from the adult tetanus boosters (Td). Unfortunately, a few years ago we started seeing a re-emergence of this infection by seeing local outbreaks in schools which made us realize that just like the tetanus and diptheria immunity wanes over time so does the Pertussis immunity. Now the CDC recommends routine use of a single dose of Tdap for adults 19-64 years of age to replace the next booster dose of plain tetanus and diphtheria vaccine (Td).

All these efforts being made to help immunize everyone is so that we can have a “herd immunity” so the bacteria never gets a chance to re-emerge and infect the most vulnerable patients like infants and children who have not had a chance to get enough vaccines to build up immunity against this infections. Therefore, if you are an adult who has had a plain tetanus shot (Td) more than 2 years ago, you should speak to your physician about getting a complete Tdap booster.

1. If you are a woman PLANNING on getting pregnant
2. A male who just found out his significant other is pregnant
3. All adults who will be around small infants (younger than 12 months)…includes all you soon-to-be grandparents, aunts and uncles!
4. Healthcare providers or professionals who will be around a lot of people because risk of transmission is high

NOTE: Women who are already pregnant should not receive the pertussis component of the vaccine. If they need a tetanus vaccine it needs to be the PLAIN Td. Hospitals are likely to vaccinate women with the Tdap booster right after delivery of the baby while they are still in the hospital so the babies are protected.