Whooping cough (also called pertussis) is on the rise. Experts at the Texas Department of Health and Human Services report that pertussis outbreaks typically occur in three-year to five-year cycles. In 2013 about 4,000 cases were reported in Texas—the most cases since 1959. Since 2013 was considered a “peak” year, the next outbreak could be imminent.

Babies are particularly vulnerable to transmittable diseases. Because about 90 percent of deaths from pertussis occur in babies, doctors are now recommending “cocoon immunization.”

What is Cocoon Immunization?

About 80 percent of the time, babies get transmittable diseases from parents, brothers, sisters and close relatives. Vaccinating those who are in frequent and close contact with the baby creates a cocoon of protection around her. The American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) recommend cocoon immunization.

What is Whooping Cough?

Whooping cough is an infectious disease caused by the bacteria B. pertussis. It is extremely contagious and is spread through the air by tiny droplets when an infected person coughs or sneezes.

Doctors diagnose whooping cough when a child has had a cough that won’t go away for 2 weeks or more and has one of the following symptoms:

  • Coughing fits
  • A “whooping” sound
  • Vomiting after a coughing fit

Babies with whooping cough have different signs and symptoms than children. They may gag or gasp. They may have short pauses in their normal breathing pattern (called apnea) and a slow heart rate.

How Serious is Whooping Cough in Babies?

Whooping cough is very serious in babies. More than half of babies who get whooping cough must be admitted to the hospital for treatment. Many babies develop breathing problems, such as apnea and pneumonia. Sometimes, whooping cough is fatal.

How Can I Protect My Baby?

In the US, pertussis immunization is provided by the combination vaccine DTaP. This vaccine protects against diphtheria and tetanus as well as pertussis. Because babies can’t be immunized before they are 2 months old, cocoon immunization (vaccinating people who will be in close contact) helps protect babies from this disease.

Who Should Be Immunized?

The most important person that should be immunized is the mother, ideally during the last 3 months of pregnancy. Antibodies from the mother naturally transfer to the baby and provide protection until the baby is old enough to get the vaccine.

All children should have a series of five DTaP vaccinations. The first three are given when the baby is 2, 4 and 6 months old. The next dose is given at 15 to 18 months and the final dose before the child starts school at around 4 to 6 years old. Visit the CDC’s website for the Recommended Immunization Schedule for Children and Adolescents.

Protection from the initial DTaP vaccination series fades over time. There is now a Tdap booster available for preteens, teens, and adults. It contains a reduced dose of the diphtheria and pertussis vaccines.

How to Create the Cocoon

The best time to create the cocoon is while you are still pregnant. Here are some steps you can take, both before and after your baby is born:

  • Talk to your obstetrician about getting the Tdap vaccine during every pregnancy, even if you have had it before. The American College of Obstetricians and Gynecologists (ACOG) recommends vaccination between 27 to 36 weeks.
  • Make sure everyone in the household is up to date on their immunizations. This includes the father and all siblings. If the mother isn’t immunized during pregnancy, she should get the vaccine before leaving the hospital or birthing center.
  • Talk to others who may come in close contact with the new baby about the importance of cocoon immunization as soon as possible. This includes grandparents, aunts, uncles, caregivers, nannies and babysitters.
  • Send a reminder note or email several weeks before the baby is born to everyone who may come in close contact with the baby. Explain that being up to date with pertussis immunization is mandatory, not optional.
  • Keep the baby away from anyone who is coughing.
  • Contact your pediatrician right away if your baby starts coughing.

The Texas Vaccines for Children Program (TVCP) partners with local physicians to help increase access to immunizations for children. The following groups of children younger than 18 years old may be eligible for free or low cost vaccinations:

  • Uninsured or underinsured children
  • Children who are covered by CHIP
  • Children who are of Native American or Native Alaskan heritage
  • Children on Medicaid

For more information, visit immunizetexas.org.

Brenda Schoolfield is a freelance medical writer who splits her time between Austin and Seattle.

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