Aileen M. Marty, M.D.
Director, FIU Health Travel Medicine Program and Vaccine Clinic

Florida Department of Health officials report five confirmed cases of whooping cough in Broward County this year; four of them within the past few of weeks. The latest cases include three adolescents and an infant.

Although these numbers pale in comparison to the epidemic in California which saw more than 10,000 cases last year, and already more than 400 cases this year, Florida health officials are urging residents to take preventive action.  Whooping cough is serious, each year there are about around 40 million pertussis cases worldwide resulting in 200,000-400,000 annual deaths.

Whooping cough, also known as pertussis, is a terrible, highly contagious, and sometimes deadly bacterial infection that can be prevented with a vaccine.

There are vaccines for infants, children, preteens, teens and adults.

The childhood vaccine used for all five childhood doses is DTaP.  In the US we give DTaP at 2 months, 4 months, 6 months, 15 to 18 months, and 4-6 years.

The pertussis booster vaccine for adolescents and adults is called Tdap (We use the lowercase “d” and “p” in Tdap to indicate that the vaccine has a lower dose of diphtheria and pertussis components, as compared with the DTaP vaccine).  The Advisory Committee on Immunization Practices (ACIP) recommends that people who properly received the 5 childhood DTaP vaccines receive booster vaccine, Tdap sometime between the age of 11 and 18, and a second Tdap booster between the age 19 and 64 years and a third Tdap in persons after age 65 years.

The 2012 outbreak of pertussis raised concerns about the duration of immunity and we now know that protection from the safer DTaP fades faster than the old vaccine and children may be unprotected 5 years after their last standard whooping cough vaccine, in other words a child who received their last DTaP at age 4 may be unprotected after the age of 9 years and until they receive the first Tdap booster sometime after age 11, and there is discussion that the recommended number of boosters may be increased.

It is strongly recommended that pregnant women receive the vaccine; in fact the recommendation is that women should receive the vaccine during each pregnancy irrespective of the patient's prior history of receiving Tdap (or Td). 

In addition to the gap in immunity, studies have shown and public health officials have unfortunately seen an increase in the number of whooping cough/pertussis cases nationwide due to a persistent anti-vaccine campaign that is unfounded and puts everyone at risk.

“Pertussis is a very serious, yet preventable disease. Babies and young children often get the disease from family members so we urge the community to seek vaccination right away to decrease the risk of infection,” Dr. Paula Thaqi, Director, Florida Department of Health in Broward County, said in a statement. “Vaccinating children helps protect the health of the whole community, especially those people who cannot be vaccinated.”

Whooping cough starts with the usual cold-like symptoms: runny or stuffy nose, sneezing, mild cough, but it can last for months (10 weeks).  After the first week or so of symptoms the cough becomes worse and worse.

In children the severe coughing fits cause them to gasp for breath and make the classic "whooping" sound that gives this infection its common name. These terrifying coughing fits, which take place mostly at night, make it hard to breathe, eat, drink, or sleep. Babies may stop breathing and both babies and young children often turn blue from lack of oxygen, and may vomit after the fit. The coughing fits can recur with the next respiratory infection.

The bacterium (Bordetella pertussis) responsible for whooping cough was a notorious major childhood illness and a leading cause of death in the pre-vaccine era. It still kills up to 400,000 children a year worldwide, according to the World Health Organization. Pertussis has killed nearly 300 children in the United States since 2000, almost all of them babies younger than 3 months old.

Vaccines for whooping cough/pertussis are available at the FIU Health Travel Medicine Program and Vaccine Clinic. For appointments, call 305-FIU-DOCS (305-348-3627).