Expecting Parents and Grandparents – Protect Your Baby from Whooping Cough
In my previous work as a nurse at the Children’s Hospital of Montreal, I cared for babies who were sick from whooping cough, also known as pertussis. In Canada there are between 1,000 to 3,000 cases of pertussis every year and 1 to 3 deaths, mostly in babies less than 3 months of age who have not yet been vaccinated against the disease.
Adults are a major source of transmission of pertussis to babies. Household contacts are responsible for 75-80% of pertussis transmission to unvaccinated infants. If you are an expectant parent, grandparent, aunt, or uncle, then this blog is for you.
What’s the Big Whoop?
Pertussis, or whooping cough, is a serious infection of the respiratory tract caused by a bacteria called Bordetella pertussis. It is easily spread through close contact with nose and throat droplets of infected people through coughing and sneezing, sharing cigarettes, food, or drinks. It can spread during the early stages of infection when symptoms are mild and an infected person might not be aware they have the disease. If left untreated pertussis can spread for up to 3 weeks after the cough starts.
The initial symptoms are similar to a common cold including runny nose, sneezing, low-grade fever and coughing. Over the next few weeks it can lead to the characteristic “whooping cough” causing a series of severe, repeated, and forceful coughing spells that can end with a whooping sound. It is more common at night and can lead to difficulty breathing. Whooping cough can continue for 6-12 weeks and lead to complications.
Pertussis can only be confirmed by your health care provider examining your physical symptoms and obtaining lab results. Early treatment with antibiotics can help reduce the spread of infection and length of illness. Antibiotic treatment can also be given as prevention to those at high risk of serious illness who have been in close contact with someone that has pertussis.
Pertussis in Canada
The pertussis vaccine was introduced in Canada in 1943, leading to a significant decrease of the disease from an average of 156 cases per 100,000 population in 1938 to as low as 5 cases per 100,000 population between 2005-2011. Despite vaccination programs, outbreaks of pertussis continue to occur throughout Canada. According to the BC Centre for Disease Control, cyclical peaks occur every 3-5 years. Since 2012, pertussis incidence in BC has continued to increase in Vancouver Coastal and Fraser Health Authorities, Vancouver Island Health Authority, and the Northern Health Authority regions of BC. Lower vaccination rates, missed booster doses, and waning immunity contribute to pertussis outbreaks in Canada and worldwide.
Why are Infants Most at Risk?
Pertussis is serious for infants as the most severe complications, including death, occur in this age group. About 50% of infants with pertussis younger than 12 months of age will need to be hospitalized, and about 1 in 170 may die. Complications of pertussis in young infants include:
- Apnea (periods of interrupted breathing)
- Pneumonia
- Seizures
- Brain damage
- Dehydration
- Nosebleeds
- Hernias
- Ear infection
- Lung collapse
- Rectal prolapse
- Subdural hematoma (buildup of blood on the surface of the brain)
- Death
Young infants are particularly vulnerable to pertussis infection as they have not yet completed their pertussis vaccine series to ensure they develop immunity. Infants do not develop adequate levels of immunity until they receive their third dose of the vaccine. In British Columbia, infants receive the pertussis vaccine at 2, 4, and 6 months of age, followed by booster doses at 18 months, 4-6 years and in grade 9.
Pertussis in Adults
Older children and adults can also develop complications of pertussis. While complications tend to occur less frequently in adults, they can include pneumonia, rib fractures from severe coughing, urinary incontinence, fainting, and weight loss.
Pertussis Vaccine
The vaccine to prevent pertussis is only available in combination with tetanus and diphtheria (TdaP) and is part of the routine infant vaccine series followed by a booster dose is Grade 9. Immunity from the pertussis vaccine tends to wane over time. The BC Centre for Disease Control recommends a one-time booster dose of pertussis vaccine for adults born in 1989 or earlier. A booster is specifically recommended for adults who are in close contact with infants younger than 12 months of age, pregnant women, and international travellers due to increasingly frequent pertussis outbreaks worldwide.A booster is also recommended for people who had pertussis disease as natural infection does not provide long-term protection and repeat infection can occur.
Pregnant Women
Women should receive a pertussis vaccine (TdaP) in every pregnancy, regardless of when the last dose of TdaP or tetanus/diptheria vaccine was given. The TdaP vaccine is safe and effective for pregnant women and their babies. When a pregnant woman receives the TdaP vaccine pertussis antibodies are passed to the baby before birth, which help to protect the baby against pertussis in the first few months of life. The ideal time for a pregnant woman to receive the TdaP vaccine is between 27 to 32 weeks of pregnancy but can be given at 13 weeks up to the time of delivery. Receiving a TdaP vaccine between 27 to 32 weeks of pregnancy has been shown to lower the risk of pertussis in infants younger than 2 months of age by 78%.
Travellers
Pertussis is a risk worldwide, with about 20 to 40 million cases and 400,000 deaths occurring every year. Outbreaks of pertussis occur in both developed and developing nations, so travellers should ensure they have received their pertussis booster before departure to all destinations, including the United States. You want to return from your trip with great memories, NOT pertussis!
Vaccine Cost
The pertussis vaccine (TdaP) is publicly funded and provided free to certain people:
- Infants and children as part of their routine vaccine series
- People receiving their Grade 9 TdaP booster
- People born in 1989 or earlier who missed their grade 9 TdaP booster
- People who have never been immunized who are starting their primary vaccine series
- Pregnant women
Anyone who qualifies for a free TdaP vaccine can request the vaccine at their family doctor or contact their local Public Health Unit.
The vaccine is recommended but not provided free for all adults who have not previously received a dose of pertussis vaccine in adulthood. The TdaP vaccine is available for purchase at TravelSafe Clinic.
Get your Pertussis Booster!
If you are soon-to-be grandparents, expectant parents, or will be around young babies for any reason it’s time to get your pertussis vaccine. You can help to prevent the spread of pertussis to young infants by getting vaccinated. Book an appointment for your TdaP booster at TravelSafe Clinic by calling us a 604-251-1975 or emailing us at info@travelsafeclinic.ca
