Talk to me about pertussis.

[mrs.t]

I have a nearly 6 mo DS who has been partially vaxed. He has had one dose of DTaP and one dose of Hib. Following DTaP, he had a reaction that was not "serious" but not something I would like to experience again. I'm ok with my new decision to stop vaxing altogether, but pertussis is the disease that scares me, so I'm just looking for a little more info so I can stop obsessing over it. I don't want to debate over whether or not I should vax, just looking for info on the disease. So here are my questions:

1. Does breastfeeding have any effect on the severity of pertussis? I know that it does not protect against it, but does it do anything?

2. If your child has had pertussis, what worked for you as a treatment? I have read some on these boards about SA, so I'm wondering if it would be a good idea to start treating with it in the event that DS comes down with a cold, in case it might be pertussis.

3. I have read that "infants" have the most chance of being hospitalized with pertussis. Since DS is almost 6 months, is he out of the "danger zone" statistically? Or is it not until he is over a year old?

4. How contagious is it? I know it's "highly" contagious and airborne, but would it take someone in the household to spread it to him, or is it even more contagious, where, say, a trip to the mall might potentially expose him?

For the record, he is EBF, he does not attend daycare, and he does not have any older siblings.

[ema-adama]

This will probably be moved to H&H as it is not a vaccine question, but rather a question about the illness.

From my understanding breastfeeding does not have a role to play in protecting an infant from pertussis. The largest risk is to children under 6 months. I seem to remember that most cases of pertussis in infants were from family members - not outings to the mall.

I have not had to treat pertussis, so no answers there.

I would guess that an EBF baby who is at home with a well nourished mother would probably handle pertussis better than a baby without those advantages - but that is pure speculation.

I hope that you get some good answers from others who have BTDT.

[mrs.t]

Thank you for the response...if the post needs to be moved, that is fine. I just figured those who had not vaxed their children against pertussis would know a little about it.

[Gemini529]

I am by no means an expert, but here are my 2 cents on this as I just went to the ped a few days ago for the 4 month check up (I am at least delaying vaxes til 6 months and considering getting DTaP next time.)

He told me that even if the baby has not finished the series, if they've had one or two of the shots, the severity of the disease, should they contract it, will be lessened. So according to my ped, since he has received one of the shots, he might not get it as bad if he does get it.

Also, he said something to the effect of if I do choose to never vaccinate, that's my decision, but I might want to nurse him until he's 8. He was most likely kidding and being sort of condescending, but nursing is good for their immune system so I guess it would probably help him fight it off better.

Sorry I'm not that much help!

[mrs.t]

Thanks! I thought I remembered reading that somewhere, that if he had one dose it would be helpful. I appreciate the response.

[Marnica]

SA is extremely effective in reducing the paroxysmal coughing spasms that are characteristic of WC. Given at the right dose (to bowel tolerance) over the course of a 24 hour period, it has been effective (anecdotally since they would never actuially study this!)at shortening the time and severity of symptoms.

[fishmom]

I've been doing some research on pertussis as well w/the outbreak here in CA and am so frustrated with the lack of complete info out there.

My aunt had it as a child and is convinced she is a "carrier" and that she can give it to my 2 month old. She insists on getting the booster and now says she can't be around lo for at least 2 weeks. So, does that mean if I decide to get the shots for me or my older dc, that we can't be around the baby? It doesn't make sense to me.

Everything I have read says the immunization effect wears off after 5-10 years so we all (adults, teens, etc) could potentially get WC and pass it on to babies. They are pushing for adults/teens to get booster shots here in CA, especially the hispanic population as they (for some reason) have been the most effected. 8 of the 9 infants that died here this year were hispanic.

[luckiest]

I don't have much in the way of answers to your specific questions, but I think looking at some of the numbers could put your mind at ease a bit.

Pertussis isn't controlled by vaccination like most diseases because the vaccine wears off after 5-10 years. It has a predictable pattern of spiking every 4-5 years (we're seeing an outbreak now, the last outbreak was 2004-2005). I believe (and I could be mistaken) that the peak season is July-August, so hopefully we'll see reported cases tapering off soon.

I'm in California, where the outbreak is, and I'll admit that it did freak me out a little. I'm due in November with our first, and although I hadn't planned on vaccinating, I looked into pertussis since it seems to be everywhere (according to the media) and actually can be a big issue for tiny ones (I think, like pp said, 6 months and older is out of the "danger zone"). Initially I worried that DH would pick it up on the commute and bring it home or something like that.

Except that I actually looked at the numbers in my county - in SF county, where "an epidemic is raging" there have been 26 cases (that was as of a couple weeks ago). 26 cases of anything, in a population of 800,000, doesn't scare me too much.

Still, my decision to not vaccinate against it mostly rests on the fact that there isn't a vaccine for infants that only includes pertussis. To protect an infant, they'd have to get the DTaP, and I personally don't have any compulsion to immunize against diptheria or tetanus.

I won't get the adult booster because I have an auto-immune disease, but we're considering having DH get it before babe gets here, just so he doesn't bring it home.

I would look up how many cases have been reported in your county - that might be enough to put you at ease right there. If there have only been a handful, and your babe is EBF and stays at home and is over 6 months - I'd say you're pretty much out of things to worry about.

[mrs.t]

Thank you for all of the replies. I do feel better about my decision, now. I actually did look up the stats for my area and it was something like 9 cases in a population of over 500,000.

Also, for those of you that were talking about the effectiveness wearing off, I actually found a study that said it starts to decrease in effectiveness after only 1 year!!!

It makes me wonder why we bother to vaccinate for it at all.

[EVC]

(anecdotally since they would never actuially study this!)

Wasn't there a study by a doctor in Japan?

[EVC]

Ah, I think this was what I was thinking of...


http://www.seanet.com/~alexs/ascorba...-p1884-eng.htm

[mrs.t]

Thank you for the link! I love having studies to back things up!

[by-the-lake]

Hi,
I hava a pertussis story. My vaxed teenager and my unvaxed 11.5 month old have it right now. Our doc says my teenagers vax has worn off and even if my unvaxed baby had started the series, he would not be fully immunized anyways. My middle child is 7, had the vaccines, and does NOT have pertussis. I think my 7 year old carried it home. Just a hunch.
I do laugh because after the test came back positive today, I had 3 public health nurses ask me if I am going to vaccinate against pertussis now. Um, no, I told them, we now have natural aquired immunity, thanks anyway!
That aside, when I see my baby in a coughing spell turning red in the face and blue in the mouth, I wonder if I made the right choice.....

[Mosaic]

Moving to H&H for more advice from mamas who have BTDT!

[Gemini529]

Originally Posted by Marnica

SA is extremely effective in reducing the paroxysmal coughing spasms that are characteristic of WC. Given at the right dose (to bowel tolerance) over the course of a 24 hour period, it has been effective (anecdotally since they would never actuially study this!)at shortening the time and severity of symptoms.

This might sound like a dumb question but what is SA? I'm no good with these acronyms but I've seen this one before and don't know what people mean by it. Please forgive my ignorance!

[mrs.t]

SA=Sodium ascorbate. It's a form of vitamin C that the body can use more easily than regular vitamin C.

[Gemini529]

Originally Posted by mrs.t

SA=Sodium ascorbate. It's a form of vitamin C that the body can use more easily than regular vitamin C.

Ahh! Thanks I tried looking it up on an acronym search and it came up with about 1,000 possibilities!

[ameliabedelia]

Breastfeeding isn't going to 100% protect your child from any illness. However, formula feeding increases the risks of your child getting ill and increases the chances of your child having serious complications from the disease.

To answer your second question, I have gone through periods where I was completely paranoid and treated every cold as though it might be pertussis with SA right from the first sniffle. I've since eased up on worrying about it, but I do still give everyone SA when they have a cold.

Pertussis is airborne, so I suppose it's possible for him to get it from the mall, but not very likely. He's be more likely to get it from a family member that might lean over his face to play with him or kiss him, etc. Usually contact with strangers in the mall isn't that close.

One good thing, is that he's already 6 months and with each passing month he gets further and further away from the "danger zone"

[lizajane30]

Originally Posted by luckiest

I won't get the adult booster because I have an auto-immune disease, but we're considering having DH get it before babe gets here, just so he doesn't bring it home.

The vaccine does not prevent transmission. Just something to keep in mind.

Also, I know this is anecdotal and all, but my whole family have it now. DS is 4.5 and had 4 of 5 in the DTaP series. DD (23 months) is unvaxed and has had it the worst, but she also has the smallest airways so that probably figures in. DH and I were both fully vaxed as kids, but are nowhere near current on boosters; it's been very mild for us. We've been treating it with steam, rest, and a few homeopathic remedies. We got it from playmates. Both vaxed and unvaxed kids and adults in our community have had it recently. We're in the SF Bay Area, so I guess we're part of the "epidemic."

[poppan]

We are fairly sure we had it... at least our pedi thought so, but we didn't actually do the culture to confirm because it would have taken a week (too late to do anything differently as far as treatment) and would have meant reporting to the state (I stopped vaxing at 2 months of age).

I started feeding both kids lots of vitamin C (I didn't do the SA powder, just gave them chewables like every hour) even before we went to the pedi. I finally went to the pedi because DD (3 y.o.) started doing the whoop and then threw up afterwards, exactly how they describe the symptoms. But it turned out to be just that one night, we had a few more nights of bad coughing (but no whoop) and then it got better at night and gradually they didn't seem sick at all.

DH and I both felt weird and like we were just dragging through the day, he even had difficulty breathing. DS (also 3 y.o.) did not develop the whoop but otherwise had same symptoms as DD. It felt like a long lingering bad cough for all of us and I recall that the start of it was a bit strange, but now can't remember exactly what kind of strangeness it was.

Overall I would say it wasn't too bad but I think we had a very mild case. And of course my kids are older.