Pertussis, or whooping cough, is a vaccine preventable disease which has been on the rise across the US and South Carolina. There have been over 32,000 cases including 16 deaths in the U.S. this year according to the CDC.
Pertussis often causes a cold type illness for a week or two that progresses into a worsening cough. The cough can turn into “paroxysms” in which children will cough repeatedly and have trouble catching their breath. They can cough so hard that they can vomit or turn blue around the mouth. Infants can develop pneumonia, seizures, encephalitis, or even death.
The good news is that we can prevent our kids from getting pertussis by vaccination. Infants are vaccinated at 2 months, 4 months, 6 months, and 18 months. They then receive booster vaccines at 4 and 11 years old. We can also limit our infants’ exposures to pertussis by making sure that our family members are vaccinated. Children and adults are vaccinated against pertussis as children, but over time our immunity wanes. The Advisory Committee of the CDC recently met and recommended that pregnant mothers be given the Tdap vaccine between 27-36 weeks gestation as reported in AAP Smartbriefs and CNN Health. Mothers of newborns have previously been offered the pertussis vaccine after delivery at the hospital. It has been reported that by vaccinating a mother during pregnancy, maternal antibodies to pertussis are transferred to the newborn to protect them until their vaccination. It is important that we make sure that everyone is vaccinated who will be around a newborn with a Tdap shot to provide a cocoon of immunity around the newborn.
When to call your pediatrician…
It is important to call your pediatrician if your child develops a frequent or severe cough, especially if they have any blue color change, vomiting after cough, or acts tired or sick.
With the holidays approaching, one of the more frequent questions I will get while rounding in the newborn nursery is, “when is it safe to take my newborn out?” The answer is not as simple as it may seem.
The quick answer that most pediatricians will give is 6-8 weeks. Infants in the first 2-3 months of life are susceptible to numerous infections both viral and bacterial. Some of these include RSV, pertussis (aka whooping cough), and influenza. Newborn infants do not have the immunity to protect themselves from these infections. If your new baby were to have infection or fever > 100.4, then there is a strong likelihood that your baby would need hospitalization for 2-3 days, and require numerous invasive tests in order to exclude serious infection. Sometimes what seems to be a simple “cold” for most will require monitoring in the hospital when a new baby is affected. These are the most common reasons most pediatricians recommend avoiding close contact in a baby’s first 2 months of life.
Most pediatricians understand that this is not always practical to a family’s day to day routine. Most do not expect new parents to lock themselves in their home and not leave for 8+ weeks. Here are a few tips to help keep your baby well when out and about.
1) Have family and friends visit your baby at your house. This way parents are able to “screen” for anyone sick who may want to visit.
2) Avoid large gatherings, especially gatherings with many small children. Parents have better control over who is touching and holding their baby if gatherings are small or hosting visitors in the home.
3) Make sure anyone holding your new baby wash their hands or use hand sanitizer. Also, keep extra sanitizer in a diaper bag, purse, or stroller when out.
4) If out running errands, then go in the morning when less people are out. Avoid crowded areas with poor ventilation (i.e. the mall).
5) Avoid extreme heat or extreme cold when going out. A good rule of thumb is to dress baby in the same number of layers that an adult would be wearing. A light blanket or jacket can always be added if necessary.
Do not stay cooped up in the house for 2 months. Follow the above tips, use good common sense, and enjoy going out and getting some “fresh” air with your new baby.
William Darby, MD