Your Nagging Cough Could Kill Someone’s Baby
Jan 15, 2014

I could hear it clearly from across the auditorium.  A distinctive cough in a very small child.  It was painful to my ears and I brought a sinking feeling to my heart.  My daughter glanced over at me, alerted by the same sound, and we both mouthed those two horrible words…”whooping cough”.

In 2012 48,277 people were diagnosed with a bacterial infection known as Bordetella pertussis.  Also known as whooping cough, pertussis can cause severe coughing that can last for weeks or even months.  It is spread through droplets in the air and is extremely contagious.  In fact, when someone in the house has it, virtually everyone else in the house that is not immune will also get it.

In children pertussis is often identified by the “whooping” sound that is heard as they desperately try to catch their breath between coughs.  The coughing spells can be so bad that it’s difficult to eat, drink, sleep or breathe for weeks.  Pertussis can also lead to pneumonia, seizures, brain damage, mental retardation, and in some cases even death.

In adolescents and adults the disease typically appears as a bad cold with a prolonged cough and often goes undiagnosed.  The classic symptoms are not always present and people don’t always know when to seek help for a cough.  To make matters worse, even if a patient does visit the doctor, an accurate diagnosis of pertussis can be challenging.

Most people don’t realize that the nagging cough they have could end up killing someone’s baby. Maybe even their own.

Am I being dramatic?  Overstating the concern?Families_carter

No.  Not at all.

Ninety percent of the deaths associated with pertussis occur in children under the age of one.

Consider the case of Landon Carter Dube.

Four years ago today, Felicia Dube brought her five-week old son Carter to the doctor for a check-up.  Her only concerns were that he had been spitting up a bit and seemed cranky at night.  The doctor suggested switching his formula and monitoring his crying in case it was colic.  Though he seemed to improve at first, four days later Carter was running a low-grade fever.  Upon returning to the doctor’s office the nurse practitioner expressed concerned about Carter’s breathing rate and hydration level and he was taken by ambulance to the hospital.  Within days Carter was fighting for his life on a respirator, oscillator and eventually an ECMO machine.   Carter’s mother Felicia recalls the horrible details as the hospital staff did all they could to provide Carter with cardiac and respiratory support.  She explains,

Carter4_DSC_0069_edited-1“It was hard to stand back and look at my sweet baby boy swollen to nearly twice his original size. They had him under a heat lamp and two huge medicine trees held all of  the medicines that were working to keep him alive. It is difficult to forget  the machine that was also monitoring his heart and blood pressure which was  constantly chiming, alarming us that something wasn’t right. It was like a bad  dream where we just couldn’t wake up. We had asked the doctors to always be honest and to let us know when it got to the point that they were doing things to Carter and not for him.”

This is not a “story” to Felicia and her family.  These memories are forever embedded in their hearts.  They will never forget Carter and the way in which he earned his wings after losing his battle with pertussis on January 28th – just nine days after first arriving at the hospital.  In the video below you can see how Carter’s body reacted to the infection and you can begin to understand the suffering he and his family went through four years ago.

[youtube=http://www.youtube.com/watch?v=IZ_Jwf2k0jg&feature=related]

Unfortunately, Carter is not the only infant lost to pertussis There are plenty more.

Preventing further tragedies. 

In order to reduce the suffering of infants like Carter, people of all ages need to understand the importance of the pertussis vaccine (available as a Tdap booster for adults and DTaP vaccine for infants).

Babies are not fully vaccinated against pertussis until they’ve received all five doses of the vaccine (at 2, 4, 6 months, between 15-18 months, and between 4-6 years).  Evidence suggests that once children are fully vaccinated, they are 8 times less likely to become infected with pertussis during an outbreak than those who have never been vaccinated.

However, in order to maintain an adequate level of immunity throughout our lives, which can reduce the risk of contracting pertussis and passing it on to other vulnerable people in our communities, teens and adults need to get Tdap booster shots.  After an increase in pre-teen pertussis cases several years ago, scientists concluded that the vaccine induced immunity appeared to be waning among this adolescent age group.  This is believed to have been the unfortunate result of a new pertussis vaccine.  The previous pertussis vaccine,  a whole-cell vaccine, was quite effective.  But in an effort to improve safety and reduce adverse effects, it was replaced with an acellular pertussis vaccine which appears to be less effective.   To compensate for the waning immunity, a booster dose is now recommended for children between 11 and 12 years of age and also for anyone 19 years of age and older.

Additionally, in an effort to protect those too young to be vaccinated, new recommendations have been made to vaccinate pregnant women.  If expectant mothers receive a Tdap booster during each pregnancy, preferably during the last trimester, maternal antibodies can transfer to the newborn and help protect the baby from pertussis before they are able to receive their own DTaP vaccine.  Additionally, this pregnancy dose protects the mother so that she is less likely to contract pertussis herself and pass it onto her newborn.   Since statistics show that family members are often responsible for infecting their own children, the best practice is for all family members and caregivers to be vaccinated at least two weeks before the expected arrival of a new baby in order to allow time for the adults to build immunity and then cocoon the child with a shield of pertussis protection.

As I sat in that crowded auditorium hearing that horrid cough, I couldn’t help but think of what struggles may lie ahead for that child and that family.  Could that child in fact have pertussis?  Do others in the family have it as well?  How many people could be subsequently exposed?  And if it was pertussis, would the people in that auditorium be willing to get vaccinated in order to prevent themselves or another child from taking their chances with such a dangerous disease?

Please share Carter’s story and encourage others to get their Tdap booster to help prevent those nagging coughs and put a stop to whooping cough.

For more pertussis information and for specific vaccination recommendations visit these sites:  

Recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for Use of Tdap Among Health‐Care Personnel

Recommendations of the ACIP for the Prevention of Pertussis, Tetanus, and Diphtheria Among Pregnant and Postpartum Women and Their Infants

Standing Orders for Administering DTaP to Children Younger than Age 7 Years

Standing Orders for Administering Tetanus‐Diphtheria Toxoids & Pertussis Vaccine (Td/Tdap) to Adults

Pink Book, Epidemiology & Prevention of Vaccine‐Preventable Diseases


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