Whooping cough outbreaks lead to new vaccination rules

The respiratory system, as drawn by Theresa Knott.

Nearby McHenry County recently has tallied 121 cases of whooping cough. Scattered outbreaks throughout the country such as this have become a yearly occurrence, prompting an increased need to make sure your vaccinations are up to date.

The disease causes staccato coughing until the individual runs out of breath and must violently inhale more air, hence the “whoop” sound. It was once thought to be solely a scourge of the young. But recent studies show individuals need a booster shot at least once in adulthood.

The outbreaks, which include 9,000 children sickened in California in 2010, likely do not represent a new strain or vaccine failure, but are occuring because people are failing to get vaccinated.

Here at Fermilab, we have had a few confirmed cases, which were made all the more notable by a patient who suffered fractured ribs as a result of the violent coughing often linked to the illness. Fortunately, since the beginning of our vaccine adoption in 2008, we have administered hundreds of doses and are not aware of any new cases.

The CDC recommends that all adults receive a newly formulated tetanus-diphtheria and acellular-pertussis combination vaccination. Recently, the recommendation was updated to include the following groups:

  • those older than 65,
  • pregnant women and their families, which provides passive immunity to the infant and a protected environment (“cocooning”) as that immunity fades,
  • And those who in the past received the old Tetanus Diphtheria vaccination formula regardless of how recently it was received. Previously, you were to wait 10 years before getting the new formula, which adds the pertussis vaccination. Once you’ve had the new vaccine the 10 year interval with the old vaccine applies. So far, no further new formulation vaccine booster appears required.

The risk of exposure to the disease is high because an infected person is contagious for up to 21 days before and after exhibiting symptoms. Antibiotic treatment shortens this window. The disease spreads through expelled respiratory droplets. The CDC reports that pertussis affects an estimated 600,000 adults every year. Infectious disease experts estimate that there are likely many unconfirmed, milder cases taking the form of that “cough that just wouldn’t go away.”

If you’re a Fermilab employee looking for the added protection of the new vaccine, please contact the Medical Office.

—Brian Svazas, MD