With her due date less than a week away, Heidi Bruch was so busy prepping her house for an infant, and her first-born for her role as a big sister, that she didn’t pay much attention to her dry, nagging cough.

On July 9, 2010, five days after Bruch’s cough started, Caroline was born, a healthy, happy, mellow baby. Bruch’s cough, though, slowly began getting worse.

“I was having trouble catching my breath and it began waking Jon up at night,” Bruch says of her husband. “He wanted me to go see my doctor, but I pushed him off at first. I had so much going on, with a newborn and a toddler at home; when would I find the time to go to a doctor's appointment?”

Jon Bruch wouldn’t let up and decided to take a day off work to stay home with the girls while his wife went to see her physician. She was not exhibiting any cold or flu symptoms, like a fever or congestion, and tests showed that her lungs were getting enough oxygen. Bruch’s doctor determined that she was likely experiencing a mild case of asthma, for which she had been treated in her teens.

“They gave me an inhaler [like one] that I had used before, and I went home,” says Bruch.

Around that same time, Caroline began coughing, especially following feedings, and even vomited after coughing episodes. The on-call nurse said to keep an eye on her and call back if she threw up more than three times in 24 hours.

At her two week well-baby check up, Bruch told Caroline’s doctor that she was coughing and also gagging when eating. They checked her lungs, and all sounded good. The doctor said it was likely reflux, which is extremely common in infants.

Then, on Sunday, Aug. 1, Bruch and her family joined her parents, brother and sister-in-law for dinner. “I was feeding Caroline and she started to cough and have trouble catching her breath. Then she turned bluish around the mouth. I told them the doctor thought she had reflux,” she said. Luckily for Bruch, her sister-in-law is an ER nurse at Seattle Children’s. “She said she didn’t want to alarm me, but that we needed to take Caroline to the ER that night.”

At Children’s they ran X-rays looking for pneumonia, an RSV test and a swab test for pertussis, commonly known as whooping cough. The doctors determined that Caroline had pertussis, contracted from Bruch, who didn’t have asthma after all, but had pertussis as well.

“Multiple studies have shown that infants are most likely to contract pertussis from their parents, grandparents or older siblings,” says Dr. Janet Englund, a pediatrician and infectious disease expert at Seattle Children’s.

Caroline spent 23 days at Children’s, six of those days in the infant ICU.

“Pertussis-related complications and deaths occur predominantly in infants too young to have received their primary immunizations,” says Jeffrey S. Duchin, M.D., from Public Health – Seattle & King County. “Therefore it is important for adolescents and adults to receive the Tdap booster to help protect infants and young children by decreasing the risk that their family members and close contacts will get pertussis and spread the infection to them.”

The time spent in the hospital, watching helplessly as her infant fought for her life, made a real impact on Bruch, who fully vaccinated her first born and plans to vaccinate Caroline as soon as she is old enough.

“I was fully vaccinated as a child, but I had no idea that I needed a booster for pertussis,” says Bruch. “It is so important to me to let parents know that they need to be proactive and make sure they are up-to-date on their boosters; anyone that interacts with children should.

Your body may be able to handle it, but the same illness could be fatal in an infant who is not yet old enough to receive their vaccine.”

Caroline was released more than three weeks after being admitted to Children’s. A month later, she still has at least two coughing episodes a day. “I still worry,” says Bruch, “but she is doing much better.”

Amy Hatch is a Seattle freelance writer, devoted Godmother and mom-in-training.

 

What is Pertussis?

Pertussis, commonly referred to as whooping cough, is a highly contagious bacterial infection of the respiratory system. Symptoms often start out looking like cold symptoms. After a week or two, the cough gets worse and coughing spells may develop. It can be hard to breathe during a coughing spell and your child may make a “whoop” sound at the end of a spell. Your child may also vomit. Infants may not “whoop,” but may look like they’re having difficulty breathing and can turn red or bluish.

For babies, the infection can be very serious, even fatal. For older children and adults, the cough typically takes two to three months to resolve. 

 

How Can I Protect my Family from Pertussis?

You can greatly reduce the chances of you or your child getting pertussis by getting the pertussis vaccine. It is part of the DTaP (infant diphtheria, tetanus and pertussis) vaccine, which is given in five doses, most often at 2, 4, 6, and 15 to 18 months of age and 4 to 6 years of age. 

Since 2006, a one-time booster shot (Tdap) has been recommended for people ages 11 to 64. It is the first vaccine for adolescents and adults that protects against diphtheria, tetanus and pertussis. Even if you have received a Td (tetanus and diphtheria) booster in the past ten years, you may not be protected against pertussis.

“Choose to be proactive,” says Ginny Heller, Program Manager with the Immunization Action Coalition of Washington, a program of WithinReach. “Specifically ask your health care provider if you have received your Tdap booster.”

How Can I Protect my Children Who Haven’t Had All of their Immunizations Yet? 

You can protect newborns and children who haven’t yet had all of their immunizations by making sure that your children’s caregivers and family members are fully vaccinated.

“Whenever possible, women should receive Tdap before becoming pregnant,” says Heller. “Women who have not previously received Tdap should receive a dose of Tdap in the immediate postpartum period.”

Should I Delay Vaccinating my Children until They Are Older to Avoid Adverse Reactions? 

According to the Center for Disease Control, infants and young children need to be vaccinated because the diseases prevented by vaccination can strike at an early age. These diseases can be far more serious or common among infants or young children. For children under 6 months of age who get pertussis, 72 percent must be hospitalized, and greater than 80 percent of all deaths from pertussis are among infants younger than 6 months.

“People don’t understand the risks,” says Heller. “Many of us grew up not seeing many instances of these illnesses, like pertussis or measles, and so we don’t fully grasp the risks to young children. The focus has been on avoiding possible reactions – a rare exception – rather than the potential danger these diseases pose to small children.”

Resources for Parents

• Download complete immunization schedules for children, teens and adults at www.immunize.org/cdc/schedules.
• Learn more about pertussis at http://www.cdc.gov/features/pertussis.
• Receive help locating an immunization clinic near you by contacting the Family Health Hotline run by WithinReach at1-800-322-2588.

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