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1. What is pertussis?

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:

• Cough which becomes more severe after 1 to 2 weeks, cough often lasts for more than a month
• Low grade fever
• Runny nose

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:

• Unusual cough lasting 7 days or more (with or without "whoop")
• Cough that comes in bursts (intermittent)
• Vomiting after coughing spells

2. Why the increase in pertussis cases?

Likely, there are several reasons:

• Immunity decreases over time. Teens and adults that have not had a booster dose of Tdap may be more susceptible to illness.
• Unvaccinated children
• The current acellular pertussis vaccine is not as effective as the old whole cell vaccine, and we need much higher vaccination rates to prevent transmission.
• Changes in testing and increased awareness. A newer test, called a PCR, has become the dominant method of testing, and it is likely we are detecting more cases than we would have in the past.

3. When should I vaccinate?

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.