The death was the first in the state, but North Carolina has seen a three-fold rise in cases of whooping cough this year.
By Rose Hoban
State health officials announced today that a 2-month-old infant had died of pertussis, or whooping cough, in Forsyth County. It was the first death from pertussis in the state this year.
Whooping cough is an extremely infectious disease that’s spread easily from person to person usually by coughing or sneezing while in close contact. Infants that have not completed their vaccinations are susceptible to the disease, that gets its common name from the loud whooping sound smaller children make as they gasp for air after a bout of coughing.
“Small lungs, big problem,” said State Health Director Laura Gerald, who is a pediatrician.
“When adults get whooping cough, they may have prolonged coughing, but they may not even know they have the disease. But that’s not the case with infants. You don’t have that reserve breathing capacity.”
Gerald called the death a tragedy, but said her department is determined to use the situation to reinforce to the others the importance of vaccination.
State law requires all children going to pre-school and school be vaccinated against pertussis. But as people age, the immunity granted by the vaccine wanes. That means the people around an infant need to be get a booster shot.
“Any household contact of an infant under a few months needs to get a booster shot. That means parents, brothers and sisters, babysitters, grandma and grandpa, even if they’re just going to come and kiss the baby… anyone who’s around the infant should get vaccinated,” Gerald said. “No kisses without vaccination.”
North Carolina has one of the nation’s highest rates of child immunization, according to Gerald, but immunity for adults is a problem. She said the DHHS will be offering free DTaP booster shots to anyone over 7 years of age this fall, until the department runs out of supplies, in an effort to curb the spread of pertussis.
“Adults can’t find free vaccines often, and that’s who usually needs a booster,” Gerald said. “People can get them through local health departments and local health care providers. So we want you to contact your local health department or local provider to see if you’re eligible.”
In recent years, pertussis has been making a nation-wide comeback with more than 18,000 cases reported this year alone, up from a total of about 7,800 cases in 2000. Big outbreaks have occurred this past year in Maine, Washington state, Wisconsin, New York and California, among others. North Carolina has had a three-fold increase in reports of the disease in 2011-12.
“We’ve had 350 cases already in 2012 and we’re not through the year,” Gerald said.
Earlier this year, Alamance County battled an outbreak that affected close to one hundred people. County health officials there vaccinated thousands in order to contain the spread.
“In the last year, we’ve started to see a change in the epidemiology of this disease.,” said Stacey Martin, a pertussis expert at the Centers for Disease Control and Prevention. “We’re seeing increase in disease in kids aged 7- to 10-years-old that’s a concern.
“It’s been an areas of research at CDC. We’re seeing that the duration of protection has changed and is shorter now than before.”
Martin said scientists from the CDC suspect the current rise in cases stems from changes made in the formulation of the vaccine against the disease, part of the DTaP series of immunization shots given to children and repeated for early teens.
Martin said most of the children getting pertussis now are elementary school aged, it makes them sick for up to a month, but is rarely fatal. The problem comes when an elementary school-aged child gives the disease to an infant brother or sister, who has not completed their vaccine regimen.
Before the mid-90s, the vaccine was made with whole cells of the pertussis bacteria, but was changed to a recipe that uses only pieces of the bacteria. That makes the vaccine safer, but health officials are now seeing that it might also make the vaccine last for a shorter period of time, leaving children vulnerable to the disease for a few years before they get boosters in early adolescence.
But Martin said there are no plans to recommend giving the early adolescence booster shot any earlier.
“It’s challenging because that vaccine is administered with other adolescent vaccines. It’s a difficult age group to vaccinate. By moving it to an earlier age, we may risk reducing overall coverage,” Martin said.
“It’s not as simple as it sounds to change the schedule. If you move the schedule around, you can create a pocket of disease in a different age group.”