Recently, five very young children died in Los Angeles due to infection with whooping cough.
But what is whopping cough?
Whooping cough is characterized by what doctors called a paroxysmal cough, a specific type of cough which is very characteristic of whooping cough. Hard to describe with words, here is a link to a YouTube video of this type of cough found most often in those with whooping cough:
Whooping cough is caused by the bacteria Bordetella pertussis, and is also called “pertussis.” Children in the United States normally are vaccinated against Whooping cough when they received the pertussis vaccination. Vaccination against pertussis has lead to a 99 percent reduction in whooping cough cases. This is important because children with chronic medical conditions can develop a number of complications from whooping cough which include neurologic problems such as seizures and a marked confused state called “encephalopathy”, in addition to pneumonia, and these or other complications can lead to death. Whooping cough is usually much less severe in adults and older children.
Children who have whooping cough may not develop the characteristic repetitive cough until 1 to 2 weeks into their illness. Before the development of the cough, young children with whooping cough may display the nonspecific symptoms of an upper respiratory infection, such as a runny and stuffy nose, nasal congestion, low grade fever and runny eyes. In three fourths of cases, children catch whooping cough from a family member, this is because whooping cough is very contagious. Close contacts of an adult, or child, with whooping cough are usually recommended to take antibiotics to prevent the full development of whooping cough, even if such close contacts have been vaccinated. This is because vaccination wears off after about a 12 year period, and because adults and older children are primarily responsible for transmitting pertussis to young children.
Thus adequately vaccinating a population of older children and adults may be important for protecting young infants, because the majority of fatal cases of whooping cough occur in infants too young to be protected from whooping cough through vaccination.
For obvious reasons, public health officials in California are concerned that the state is experiencing the worst whooping cough outbreak in 50 years. The five children who died in California were under three months of age, and although vaccinated, their immune system would not be mature enough to mount an adequate response against the pertussis bacteria until they reached the age of six months. Public health officials are encouraging vaccination of older children and adults because such vaccination would provide a “herd immunity”, or in other words make it harder for a whooping cough outbreak to occur if a higher percentage of the population was vaccinated. Herd immunity would thus provide indirect protection for young children, especially infants less than six months of age, even though they would not be directly protected by vaccination against pertussis.