Mass. Pertussis Cases More Than Double This Year To 560

Brady Alcaide, of Chicopee, Mass., died earlier this year at two months old of pertussis.

Cases of pertussis — better known as whooping cough — have more than doubled in Massachusetts this year. WBUR’s Mark Degon reports:

Pertussis is a contagious bacterial infection of the respiratory system that causes uncontrollable, violent coughing.

There were 273 cases of whooping cough in Massachusetts last year. This year, Kevin Cranston with the infectious disease bureau at the state Department of Public Health says, there are more than 560 cases.

“We have sent out advisories throughout the state to clinicians urging them to be attentive to the possibility of pertussis, to treat it aggressively and early,” he said.

One infant death this year is blamed on the disease. Health officials say the sharp increase may be the result of vaccinations wearing off.

“There’s increasing evidence that the immunity conferred by that vaccine is waning over time,” Cranston said, “and that may be explaining why we’re seeing increased cases at this time.”

Further reading:

From first cold to grave: How two-month-old Brady died of pertussis

Pertussis vaccine update: Immunity drops sharply after last childhood dose

The whooping cough misnomer, and other facts about pertussis

Pertussis Vaccine Update: Immunity Drops Sharply After Last Childhood Dose

(Army Medicine/flickr)

Bad news for vaccines this week: a new report in The New England Journal of Medicine suggests that immunity to pertussis, a highly contagious bacterial infection also known as whooping cough, wanes after the fifth dose of the vaccine. This short-lived vaccine effectiveness likely played a role in a large outbreak of pertussis in California in 2010, researchers note.

In the U.S., children are supposed to get five doses of diphtheria, tetanus, and acellular pertussis (DTaP) vaccine before they reach age 7. Up until now, the duration of protection after those five doses has been something of a mystery, though periodic outbreaks around the country suggested that waning immunity was one cause.

Now, researchers conclude that “after the fifth dose of DTaP, the odds of acquiring pertussis increased by an average of 42% per year” and that protection wanes during the five years after the fifth dose.

Earlier this year, we reported on the death of two-month-old Brady Alcaide, who died of pertussis before he was even old enough to get his first vaccines.

But the new report offers a sobering reminder that despite the powerful protection vaccines can offer, that power isn’t infinite; and boosters are often needed. As a CDC official told me back in April: “Everyone needs Tdap vaccine as an adolescent/adult even if they were fully vaccinated with DTaP or DTP vaccine as a child.” Continue reading

The Whooping Cough Misnomer, And Other Facts About Pertussis

Brady Alcaide died of pertussis at the age of two-months. His parents are now trying to raise awareness about the disease. (Courtesy: Kathy Riffenburg)

The most important thing I learned from my reporting on two-month old Brady Alcaide, who died of pertussis, or whooping cough in January is this: it shouldn’t be called “whooping cough.”

I came to this conclusion yesterday, after recording a segment on pertussis for Radio Boston. Appearing on the program with me was Dr. Ben Kruskal, a pediatrician and director of infection control and travel medicine at Harvard Vanguard and director of infectious diseases at Atrius Health. When asked what clinicians should do when confronted with infants like Brady, who had contracted pertussis, a bacterial disease, but didn’t exhibit the “classic” violent cough or whooping sound associated with it, Dr. Kruskal said this:

“Actually it turns out that most people who have whooping cough don’t show the classic signs of whooping cough. Continue reading

From First Cold To Grave: How Two-Month-Old Brady Died Of Pertussis

Brady Alcaide, of Chicopee, Mass., died at two months old of pertussis.

Brady Alcaide — a happy, healthy six-week-old baby — got his first cold shortly after the new year.

His mother, Kathy Riffenburg, had seen her share of sniffles (she has two older daughters, 8 and 5) and didn’t think much of it. “It was just a little cough and sneeze,” she said. “I wasn’t too worried.”

But a few days later, on January 6, Brady’s fever spiked to 104 degrees. So, in the middle of the night, Riffenburg and her husband Jonathan decided to take the baby to the emergency department at Baystate Children’s Hospital in Springfield, Mass. near their home in Chicopee. Brady tested negative for flu and a common respiratory virus. By early morning, his fever was gone and the family was sent home.

Three weeks later Brady would be dead, a victim of pertussis, or whooping cough, a preventable but highly contagious bacterial disease that has been on the rise in recent decades.

At home, Brady’s breathing became slightly more labored; he’d been diagnosed with bronchiolitis, a swelling and buildup of mucus in the tiny air passages of the lungs, usually due to a viral infection. After another examination later in the week, a pediatrician prescribed albuterol to ease Brady’s symptoms.

On January 16, the Martin Luther King Jr. holiday, Brady started spitting up more and his breathing worsened. This time he was admitted to Baystate’s pediatric ICU, his mother said. A medical team assessed him; and an infectious disease doctor suggested he might have pertussis, though the diagnosis remained uncertain. Indeed, the family didn’t get confirmation of Brady’s pertussis until after his death, when a test for the disease came back positive. “I could have bet my whole life that it wasn’t pertussis,” Riffenburg said, recalling her reaction when the illness was first mentioned. “He wasn’t coughing like I would have imagined. And I didn’t know any infant who ever had pertussis.”

But pertussis, or whooping cough, or “the cough of 100 days” for its generally long duration, has been on the rise since the 1980s, according to the U.S. Centers for Disease Control and Prevention. The disease is characterized by violent, uncontrollable coughing (including the characteristic “whoop” sound) that can make it hard to breathe. But sometimes there is no “whoop.” And infants with pertussis don’t always cough, but may have apnea, a long pause in their breathing. The disease is most common in young children; babies under one are particularly vulnerable and face the greatest risk of death. Continue reading