Protecting baby from whooping cough

(Photo of Dr. Paul Roumeliotis)

Recent Canadian and American guidelines recommend that all pregnant women receive the pertussis vaccine during every pregnancy even if they have previously received this vaccine.

This is to prevent whooping cough infection in the mother, who might unknowingly spread it to her newborn baby. In addition, during pregnancy, mother’s antibodies against whooping cough are transferred to the unborn baby and can protect the newborn for several months. If you are pregnant or planning to be, please speak to your healthcare provider for more details.

What it is and how it’s spread

Whooping cough is caused by a bacterium called bordetella pertussis which is spread through the air when an infected person coughs.

Whooping cough tends to spread more easily in “close-contact” situations such as among family members and in schools. The infection begins like a regular cold that lasts for about a week and then the very characteristic cough phase develops. The cough occurs in spurts during which a child’s face turns red, has teary eyes and often vomits after the cough. There is very characteristic “whoop” sound during the cough, giving the very scary impression of choking. This cough phase can last for up to three months and typically slowly goes away on its own. It can occur during any time of the day and usually is triggered by exercise. Although it causes great discomfort, pertussis is not considered life threatening in older children and adults. However, it can be very dangerous, even deadly in infants and young babies.

Making the diagnosis

Confirming pertussis is often not easy. Sometimes the diagnosis can be made by a nasal swab test. However, even if the test is negative it does not rule out whooping cough. In most cases the diagnosis is made based on the presence of the very characteristic cough episodes.

Treating whooping cough

Antibiotics do not usually change the duration of the symptoms. Antibiotics are generally given to the individual and close contacts to stop the spread of the bacteria. The only available treatment is supportive including cough medicines (given only under the direct supervision of a physician). Of course, babies with whooping cough are hospitalized for very close monitoring, treatment and support.

How whooping cough is prevented

The pertussis vaccine has been very helpful in preventing whooping cough over the last several decades. However, the older pertussis vaccine was not 100 percent effective, wearing off with age and carrying some potentially serious side effects. It was initially given five times, incorporated with the routine vaccines schedule with the last booster given between four to six years of age. A newer version has been developed, known as the acellular pertussis vaccine, which is now recommended to be given six times including a last dose (combined with the diphtheria-tetanus vaccine) during the teenage years. In fact, adults now also need one extra booster dose. See your doctor for more details.