Whooping cough epidemic? Maybe.

California declared a pertussis (whooping cough) an epidemic the last week of July 2010. The California Department of Public Health reports 910 confirmed cases, including the death of five infants in the last eight months. The Department of Public Health is naturally urging all families to vaccinate against this disease.

The illness is a bacterial respiratory tract infection. It begins looking like most other upper respiratory illnesses with a runny nose and sneezing. There may be little or no fever. After a couple of weeks it may progress to what my pediatrician calls “bursts of numerous rapid coughs (paroxysms, a machine gun cough) followed by a loud whooping inhalation”. The final recovery can take weeks or even months. The Chinese even refer to it as the “100 day cough” because of its tenacity. The highest risk is of course for infants in the first weeks or months of life.

My pediatrician is Jay Gordon of Santa Monica. He sent an email out last month alerting his patients of the epidemic status of pertussis and letting us know not to panic but to take the health warning seriously.

Pertussis is not very easy to diagnose without lab tests and since it looks so much like a regular cold, lab tests may not be ordered. Dr. Gordon did me the favor of pointing out how hard the disease is to track by noting two divergent reports on the disease. Dr. Paul Offit of the Children’s Hopsital of Philadelphia estimates between “600,000 to 900,000” cases of pertussis each year. While the CDC reports about 5,000-10,000 per year. With this kind of disparity in reporting it’s hard to know what to do or who to listen to. Never the less, Dr. Gordon, who is not a fan of the CDC vaccination schedule thinks it could be a good time consider pertussis vaccination if you have not done so.

Dr. Gordon states in his letter, “I think the DTaP vaccine is the shot with the best risk/benefit ratio. . . This “acellular” vaccine does not contain mercury (almost no vaccines still do) and has been in use for nearly fifteen years in the United States and for quite a few years before that in other countries. DTaP vaccine prevents whooping cough and may even prevent illness or lessen the severity of illness after the first vaccine. The routine schedule includes three doses in the first six months of life, a fourth at eighteen months of age, a fifth at age five years and booster doses of a new adolescent/adult vaccine. I don’t think your babies under a year of age should be given any vaccines, including this one. The CDC and most doctors, including my colleagues in this office, disagree.”

While ultimately it’s the parents’ decision, I always take notice when my doctor who generally does not like medical intervention decides it may be necessary. You may want to talk to your pediatrician as well and see what his or her recommendation is.

Source: DrJayGordon.com, The Children’s Hospital of Philadelphia