Whooping Cough Death

[pageta]

From the Omaha World Herald

Published Thursday
May 20, 2004

Whooping cough vaccinations urged

BY NICHOLE AKSAMIT

WORLD-HERALD STAFF WRITER


Any thoughts? Should we be running out and vaccinating? I know my dh is going to ask me if he hears about this so I'm looking to everyone here to help me have a good answer. I'm assuming the infant was probably not breastfed or that obviously would have helped as the mother would have been producing antibodies and passing them along to the infant. However, perhaps it is unfair for me to assume that. I'm just wondering what everyone here thinks.

[Dmitrizmom]

I am sad for that family.

I too wonder if the baby was bf'd. Or if baby was born by C/S, or innumerable other factors...

two other things popped out at me...

1. if the mother passed the virus to the baby, vaccinating other children wouldn't have straight up prevented this case. and if you assume that the vaccine was 100% effective - wouldn't it be better to vaccinate prior to pregnancy to prevent mothers from giving it to their babies since the babies are too young to get the vaccine themselves?

2. if indeed this is such a problem, why only 1 death in 15 years? if this is so fatal and highly communicable, wouldn't you expect a much higher incidence of the disease and death than 1 case in 15 years?

[CincoDeMama]

after dealing with pertusis for the last 2.5 mos (it being known confirmed pertusis for only 1mo), i just don't know what to say about this anymore. yes, it'a a tragedy that this baby was lost to it, but what could have been done to change the baby's outcome? can't vax for it at birth, and even if ya could, the vax is not effective in many cases. when it is "effective", it wears off w/out anyone knowing it's done so.

my (vaxed for p) teenager brought this yucky stuff home from school & two of my three invaxed children got it. it's been a LONG couple of mos, dealing with health depts, schools, drs, etc. but the worst part is that everyone is over it but my 2yo (no longer bf-i wish he would!) toddler. he coughs for minutes at a time, sometimes turning all shades of red & blue it's scary stuff-and he can't be left alone for any amount of time because he might choke-and we have to make sure he takes a breath after his exhausting coughing fits. sigh.

but ya know, there's really nothing we could have done to prevent this mess. even if we had vaxed, my oldest would have still cought it-and out of 4 children, even if they were vaxed for it, statistics say that at least one of them would have gotten it. there's just no winning in a situation like this, yk?

i can tell you that lifelong immunity appeals to me a great deal-and i'm a little disappointed my 9yo didn't get it, for that reason.

[crysmomofthree]

that is so sad for the family of that baby. My son caught a confirmed case of whooping cough at daycare, the doctors didn't diagnose for a month they kept telling me it was a cold or that he was coughing to get attention. by the time They diagnosed it I had received three dr's notes that he was non contagious and could go back to daycare that made it really hard to convince work that I needed to stay home with my son. Eventually when I took him to the er for turning purple they tested him although they thought it was very unlikely. he was prescribed antibiotics whihc he refused to take so we stayed at home for two months (lost my job). the odd thing is that even though all of the children had received at least three shots of the vaccine the health department forced the parents to put their kids on preventative antibiotics, the one family who refused had to take their kid out of daycare for two weeks, this to me signals that the vaccine is not very effective

[TiredX2]

From what I have read, the incidence of Whooping Cough is astronomical. It is just rarely, rarely diagnosed.

I am convinced that I had whooping cough as a junior in high school. I would cough and cough and cough so hard I would finaly throw up. It was diagnosed as an allergy, I quit soccer to get away from the "allergen" and eventually got better.

I feel horribly for that family. What a tragic loss.

[suschi]

The key point here, "The rare death of an Omaha baby from whooping cough"

If there was a rare death from SARS, would you run out and vaccinate?

Death from flu is much more common, but how many run out and get that vaccine?

It is a tragedy for the family no matter how rare. I do wonder though about the circumstances surrounding this baby's death, less than 4 wks of age, was the baby carried around into crowds, breastfed or bottlefed. etc etc. At least the article pointed out that it was rare.

The vaccine protection, if any is obtained, is short lived, so much for "herd" immunity.

[Momtezuma Tuatara]

1st Question.

How old was the baby?

2nd. The URL for this is gone, but it was on www.stuff.co.nz

Whooping Cough cases increase
26 February 2004

...The vaccine is 80-90 per cent effective, but starts to wear off after three years.

Actually that's rubbish. the highest efficacy for the one used in NZ is 72%.

[excitedtobeamom]

I feel very bad for the family but it makes me mad that they use it to promote vaccinating. The baby was so young and I also wonder if it was BF?

Dmitrizmom-why would it matter if they were born by c-section?

[ChristaN]

Although my children are partially vaxed (& they are vaxed for pertussis), I would not rush out and vaccinate. I think that vaccinations are something that should be well thought through & not done based on fear. I, personally, chose to vaccinate for pertussis b/c I felt that the risk from the disease was greater than the risk from the vaccine, but I'm sure that not everyone agrees with me. The risk of dying from whooping cough for an infant who contracts it is something like 1 in 100, if I remember correctly. We have fairly high rates of whooping cough where I live, so I didn't want to take that risk & was willing to take the risk of any problems from the vaccine.

However, I will not be doing the booster for pertussis for my younger dd when she turns 5. By that time, I am not as concerned about the disease risk as I am about the vaccine risk, since pertussis is much more dangerous in an infant than a kindergartener. These are just my personal decisions, though.

[DarkHorseMama]

FWIW, Vanderbilt University is in trials on giving the DTaP vaccine at two weeks of age...supposedly to prevent "just this problem" of newborns getting pertussis. As my DS was recently born there, my pedi said she had considered asking me if I wanted to sign up, but she figured that if I wasn't vacc'ing to begin with, then why would I want to do an "extra" DTaP.

I had whooping cough while I was pregnant. Imagine morning sickness AND that dratted cough spasm crap. Ugh! It wasn't fun, but I got through it and moved on. My pedi also told me that most cases of transmission now are between adults or adults to children. I don't believe that having it confers lifelong immunity. The immunity seems to last several years, however.

Pedi and I are on differing sides of the fence regarding the pertussis vaccine (although she's great otherwise), but she grudging admitted that having had it recently myself and that I am breastfeeding should offer good protection. In fact, one of the reasons she said that Vanderbilt is performing this study is to see if the vaccine can be effective at that early of an age because the protective benefits of breastmilk seem to override the ability of the vaccine's mechanism. Should I NOT be surprised that most women who are going to give up breastfeeding do so within that two month window prior to the vaccinations? Hmmm...

[moma justice]

i read about an outbreak of P in a day care from i link i found here several months ago.... i do remember the article saying that almost all of the kids who go the P were vaxed against it, including the one who exposed everyone else to it.
nuff said

ps
i can make no judgement about that baby that died b/c we do not know if it was b/f, left to CIO, from a unhealthy preg (smoking, drugs, little nutrtion, etc)
those factors are a HUGE contribution to a baby's chances of warding off any illness and then surviving it after beoming ill.
we all know that

[Dmitrizmom]

from what I've read (FWIW, I can't remember where)... Babies born by c/s without a trial of labor are more likely to have respiratory issues in their first year. The compressions of contractions help to clear amniotic fluid from the lungs during labor and prepare the lungs for air. If you start with a respiratory system compromised in such a manner, it might make a difference in the baby's ability to handle diseases that affect the respiratory tract... just a thought...

and no.. I'm not slamming c/s. some are necessary and I acknowlege that... just keeping in mind that there are ramifications (as there can be with vaginal delivery as well).

[Tanibani]

Very sad. "Was the baby breastfed?" was the first question that popped into my mind.

AAP Policy Statement: Breastfeeding and the Use of Human Milk

Epidemiologic research shows that human milk and breastfeeding of infants provide advantages with regard to general health, growth, and development, while significantly decreasing risk for a large number of acute and chronic diseases. Research in the United States, Canada, Europe, and other developed countries, among predominantly middle-class populations, provides strong evidence that human milk feeding decreases the incidence and/or severity of diarrhea,1-5 lower respiratory infection,6-9 otitis media,3,10-14 bacteremia,15,16 bacterial meningitis,15,17 botulism,18 urinary tract infection,19 and necrotizing enterocolitis.20,21 There are a number of studies that show a possible protective effect of human milk feeding against sudden infant death syndrome,22-24 insulin-dependent diabetes mellitus,25-27 Crohn's disease,28,29 ulcerative colitis,29 lymphoma,30,31 allergic diseases,32-34 and other chronic digestive diseases.35-37 Breastfeeding has also been related to possible enhancement of cognitive development.38,39

The other issue that pops out to me are visitors and going out in public with a newborn. We are told to stay home the first few weeks postpartum, not to expose the baby to germs. Some new moms and dads are grocery shopping, walking around public (malls, etc...) with their newborn in the Bjorn. I see it all the time.

I remember staying home the first few weeks and feeling like I was going to lose my mind. So I sympathize.

I think American women (in particular) are eager to prove that they are fine and healthy after birth. Being seen as "independent" is something really pushed in our culture, early on. I was like that the first time... "I'm fine, what do you mean, rest?" Well, I learned my lesson... I suffered some prolapse issues within a few months... I'm now going to do what women in third world countries have done for centuries... rest for the first 40 days, recuperate from birth, and accept (and ask for) help.

Anyway, this story just reinforces for me the need to stay home in the early weeks and limit visitors. It doesn't necessarily make me wish there was a PERTUSSIS vaccine available at birth. There was a USA Today article back in December about a rise in Pertussis cases in infants before 2 months of age. The article blamed the fact that immunity wanes in young adults. So now young people/adults are passing it on to babies.

[Aquaduct]

Darkhorsemama, if Vanderbilt univ. are going to experiment giving the DPT to 2 week old babies that is a most dangerous and unethical piece of research. Because anyone who is not a dyed in the wool pro-vaccinator can see that the triple vaccine is already a very controversial vaccine for 2 month old babies, who are much bigger and more robust than 2 week olds. Since it is already damaging and occasionally maiming with brain damage (from encephalitis) these much bigger babies (hence the millions of dollars of compensations paid out to parents via VAERS), they will only the more so do with the little ones who sadly get put forward by their ignorant and poorly informed parents.

[Tracy]

T

FWIW, Vanderbilt University is in trials on giving the DTaP vaccine at two weeks of age

Can't help but wonder if Bill Frist is somehow responsible for this trial to occur at Vanderbilt.. kwim?

[Jay Gordon, MD]

Rare

Fatal illness is a fact of life and medicine. Pertussis vaccination is worth considering but parents have the right to make choices for their own children.

This baby and family had no opportunity to make a choice and the tragedy is beyond terrible. Many illnesses called pertussis are not really pertussis even though this may have been.

I continue to place much of the blame on irresponsible manufacturers and doctors who failed to make the safest vaccines and then present them in an honest fashion. They have made parents' choices even more difficult.

JNG

[CincoDeMama]

Originally Posted by Jay Gordon, MD

Fatal illness is a fact of life and medicine. Pertussis vaccination is worth considering but parents have the right to make choices for their own children.

This baby and family had no opportunity to make a choice and the tragedy is beyond terrible. Many illnesses called pertussis are not really pertussis even though this may have been.

I continue to place much of the blame on irresponsible manufacturers and doctors who failed to make the safest vaccines and then present them in an honest fashion. They have made parents' choices even more difficult.

JNG

i'm curious how pertusis might be misdx if a culture & lab are done? i understand the tests are not always 100%, but what about the typical "whoop" in my child who was dx with pertusis a mo ago? it scares me to think that he might have something else after getting this dx, and seeing SO many different drs for the same illness, kwim?

also, totally off topic but i'll ask anyway~nobody seems to know the answer to how long my child will be sick w/this dibilitating cough. on average, of the cases you've seen, how long do toddlers cough with it? we're on mo 2

[Jay Gordon, MD]

Diagnosis Of Pertussis

The culture (NP swab) is notoriously inaccurate.

The "gold standard" is finding anti-pertussis antibodies in a blood test of a non-vaccinated child.

A CBC with a high lymph count is helpful but common in many illnesses.

Many illnesses can cause a child to whoop. Doctors may be motivated to make the dx of pertussis to convince others that the illness is more common than it really is. On the other hand, pretending that whooping cough does not exist and that the vaccine is worthless is also intellectual dishonesty.

BUT, I agree that a putting the pieces together, along with a "whooping cough" that lasts for 4-6 weeks or more makes the diagnosis of pertussis quite likely.

Sadly, the illness can drag on for three months and the symptoms can be reactivated even with a cold for the months more. The contagious period is quite short and may be as short as 3-5 days.

JNG

[mollyeilis]

Wow, Dr. Gordon, that is good info to have.

So if I had had WC, they could do a blood test and find antibodies, and that would prove I'd had it? Even if no one thought so at the time? I ask because I think that I, like DarkHorseMama, had it during this pregnancy. However, I was vaxed as a child, so perhaps that would throw things off.

Maybe there's no way to find out now? None of my health care providers seemed to care about my cough; they blamed it on allergies and asthma, even though I was coughing hard enough to change colors and throw up.

About cultures...are there are doctor's offices (I'm talking about mainstream here) that actually DO cultures anymore? I haven't had a culture done in a decade, and that was at my absolute insistence, while uninsured and paying out of pocket.

[hvl25]

Originally Posted by Dmitrizmom

I am sad for that family.

I too wonder if the baby was bf'd. Or if baby was born by C/S, or innumerable other factors...

nevermind, i saw your answer. Thanks
curious, what does c/s have to do with it?