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Likely, there are several reasons:
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Pertussis is a very contagious disease of the respiratory tract caused by bacteria called Bordetella pertussis. Pertussis is also known as “whooping cough” due to the “whoop” sound made when the infected person tries to breathe after hard coughing and choking spells. Children younger than 6 months of age may not have the strength to have a “whoop.” Also, many adults and teenagers with pertussis do not have a classic “whoop.” Pertussis symptoms include:
During coughing attacks, the lips and nails may turn blue for lack of air. Vomiting can occur with severe episodes. In between coughing episodes people may feel and appear fairly healthy. Some report that coughing is worse at night. In children less than 1 year old, complications include pneumonia, convulsions, and, in rare cases, brain damage. The majority of deaths from pertussis occur in infants younger than 2 months of age. Call your health care provider if you have any of these symptoms:
Pertussis vaccination is routinely given at 2, 4, and 6 months of age and then at 1 year and 4 years, so that children have 5 doses of vaccine by the time they enter kindergarten. A booster dose of Tdap is recommended for teenagers and adults, since immunity wanes over time. Tdap is also recommended for pregnant women, every pregnancy. In Michigan, parents are allowed to opt out of vaccinating their children.