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CDC recommends whooping cough vaccine for pregnant women

Robin Wulffson MD's picture
whooping cough, pertussis, infant fatalities, apnea, hospitalization

Whooping cough (pertussis) infections have sharply increased in the United States. In 2012, the Centers for Disease Control and Prevention (CDC) received reports of more than 41,000 cases of the disease last year, marking the highest level in more than 50 years and more than double the 2011 total. Pertussis can cause serious illness in infants, children, and adults. In 2012, the disease was linked to 18 deaths, with the majority of them infants younger than three months of age. Due to this situation, the CDC is recommending that pregnant women should be vaccinated against pertussis during each pregnancy to protect their infants.

The new recommendation for pregnant women is contained in the 2013 version of the U.S. adult immunization schedule, which is updated yearly by the CDC’s vaccine advisory panel. The adult vaccination schedule was published online on January 28 in the Annals of Internal Medicine and will be available on the CDC’s website.

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Pertussis starts like the common cold, with a runny nose or congestion, sneezing, and sometimes a mild cough or fever. However, after one-to-two weeks, severe coughing can begin. Unlike the common cold, pertussis can become a series of coughing fits that continues for weeks. Pertussis can cause violent and rapid coughing, over and over, until the air is gone from the lungs and the patient is forced to inhale with a loud “whooping” sound. In infants, the cough can be minimal or not even there; however, they may instead have life-threatening pauses in breathing (apnea). Pertussis is most severe for infants; about half of infants younger than one year of age who get the disease are hospitalized. About one in four infants with pertussis get pneumonia (lung infection), and about two thirds will have slowed or stopped breathing. Pertussis can be deadly for 1 to 2 infants per 100 who are hospitalized. The CDC notes that when the source of whooping cough was identified, mothers were responsible for 30-40% of infant infections.

The new CDC recommendations note that women should receive a vaccine for tetanus, diphtheria and pertussis, together known as Tdap, toward the end of pregnancy, or between 27 and 36 weeks of gestation. The vaccination is intended to offer protection against the bacteria that causes whooping cough until infants are old enough to begin receiving their own vaccinations against the disease starting at two months of age. Women who are vaccinated during pregnancy produce antibodies to pertussis and other bacteria that are passed on to the developing infant.

Pertussis is highly contagious. People with pertussis usually spread the disease by coughing or sneezing while in close contact with others, who then breathe in the pertussis bacteria. In addition to acquiring an infection from the mother, infants can acquire the infection from other family members or other caregivers who might not even know they have the disease.

Reference: CDC