“Riley peeking at us from his hospital bed. He didn’t even seem that sick when he was first admitted. It all went downhill so quickly.” Catherine Hughes. Source: www.facebook.com/lightforriley
“I looked at our beautiful boy, who was already connected to so many tubes and wires. This was starting to feel so serious, the doctors who originally were fairly positive now looked worried and concerned. An hour or two later, one of Riley’s doctors pulled us aside for a chat. She kindly – if there is a kind way – told us that we needed to prepare ourselves for the fact that Riley could die…”
Western Australian mother Catherine Hughes’ heart-breaking account of her 32-day-old son Riley’s fatal battle with whooping cough in February 2015 (read her full story here) is a tragic reminder to all parents of newborns (and soon-to-be parents) about the importance of vaccination. Sadly, six babies have lost their life to whooping cough in Queensland since 2000. That’s six families who have watched their children die from something that could have been easily prevented.
Whooping cough can affect people of any age. For adolescents and adults, the infection may only cause a persistent cough. But for young babies it can be life threatening.
So what do you need to know to protect your family? Here are the facts:
- Whooping cough is a highly contagious bacterial disease that infects the respiratory system. It is caused by the bacterium (Bordetella pertussis).
- It is transmitted from an infected person through coughs and sneezes. The infection can also be passed on through direct contact with infected secretions from the mouth or nose.
- The time between exposure to the bacteria and getting sick is usually seven to ten days, but can be up to three weeks.
- Symptoms can appear mild at first, similar to a cold, but can progress to the characteristic coughing bouts (sounds like a whoop) combined with difficulty breathing. Infants can turn blue from lack of oxygen.
- Left untreated, whooping cough can lead to bacterial pneumonia and, especially in infants, seizure, encephalopathy, or death.
- Vaccination is the best way to protect your family.
Who is most at risk?
Infants under six months of age are the most at risk of contracting the illness and suffering serious complications because they do not yet have the full protection provided by the first three vaccine doses recommended under the National Immunisation Program Schedule. Most hospitalisations and deaths occur in babies less than six months of age.
Signs and symptoms
Whooping cough often starts like a cold with a runny nose, sneezing and tiredness over several days and then the characteristic coughing bouts develop. These bouts can be severe and frightening, and may end with a crowing noise (the ‘whoop’) as air is drawn back into the chest.
When in doubt, take your child to the doctor right away. Infants can become very ill very quickly.
Coughing episodes are frequently followed by gagging or vomiting. During coughing attacks, a child’s breathing can be obstructed and they may become blue or stop breathing. The bouts of coughing may continue for many weeks even after appropriate treatment.
Babies under six months of age, vaccinated children, adolescents and adults may not display the typical whoop. Even in adults, whooping cough can cause significant problems with the cough persisting for up to three months, and other symptoms, such as sleep disturbance or, rarely, rib fracture.
Treatment
Treatment is a course of antibiotics which reduces the time a person is infectious to others and may reduce symptoms if given early in the disease. To be effective, antibiotics need to be given within 21 days of the start of general symptoms or within 14 days of the start of the bouts of coughing.
Vaccination
Vaccination is the most effective way to control whooping cough and is recommended as part of the National Immunisation Program Schedule. The vaccine is funded for:
- Infants aged 2 months (vaccines due at 2 months can be given from 6 weeks), 4 months and 6 months
- Children aged 4 years (vaccines due at 4 years can be given from 3 years 6 months)
- An additional dose of whooping cough vaccine is recommended for children at 18 months of age, but this is not currently funded under the national program.
To ensure full protection at the right time, it is important that all the doses of the vaccine are given at the recommended times; although catch-up vaccinations can and should be given if vaccines are delayed for some reason.
A booster dose is also recommended – but not funded – for any adult who wants to reduce the risk of infection and hasn’t had a pertussis booster in the past ten years. Vaccination is particularly important for people living with or caring for babies under six months (e.g. fathers and grandparents). The vaccine should be given at least two weeks before contact with the infant.
Adults working with infants and young children (under four years of age) and all health care workers should receive a dose of pertussis vaccine. A booster dose is recommended every 10 years.
Like all medications, vaccines may have side effects. Most side effects are minor, last a short time and do not lead to any long-term problems. Possible side effects of whooping cough vaccine may include fever, redness and soreness or swelling where the injection was given, nausea, headache, tiredness and aching muscles. More serious side effects are extremely rare but can include severe allergic reactions.
Protecting newborns from whooping cough
Pregnant women can safely help protect their babies by getting vaccinated – ideally between 28-32 weeks of pregnancy onwards. The vaccine antibodies cross the placenta and help protect the newborn until they can receive their first vaccination at six weeks of age.
The vaccine is safe and studies show 1 2 there is no increased risk of adverse pregnancy outcomes (such as stillbirth, fetal distress or low birth weight) related to pertussis vaccination during pregnancy. Read more
The whooping cough vaccination for pregnant women is now promoted by all Health Departments in Australia and in several other countries: the United States, the UK, New Zealand and Canada.
Where and how to get the vaccinated
The Queensland Department of Health provides free a whooping cough vaccine for women in their third trimester of each pregnancy. See your GP and make an appointment to have your whooping cough vaccination at 28 weeks of your pregnancy. It may be one of the most important things you do as a pregnant woman or if you are planning a pregnancy.
For more information, call 13 HEALTH (13 43 25 84) or see your GP.
Useful websites
www.vaccinate.initiatives.qld.gov.au/pregnancy
www.qld.gov.au/health/conditions/immunisation/benefits/index.html
www.qld.gov.au/health/conditions/immunisation/increased-risk/pregnant-breastfeed/index.html
1 Munoz FM, Bond NH, Maccato M, et al. Safety and immunogenicity of tetanus diphtheria and acellular pertussis (Tdap) immunization during pregnancy in mothers and infants: a randomized clinical trial. JAMA 2014;311:1760-9.
2 Kharbanda EO, Vazquez-Benitez G, Lipkind HS, et al. Evaluation of the association of maternal pertussis vaccination with obstetric events and birth outcomes. JAMA 2014;312:1897-904.