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Pertussis: Infants
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Pertussis... called “whooping cough,” incidence has been increasing across the United States. There have been 26 infant pertussis deaths in Texas since 2000 in 21 different counties. During this time period there were numerous hospitalizations of Williamson County residents due to pertussis, but no pertussis deaths. Texas Department of State Health Services (DSHS) Health Service Region 7 (HSR 7) has experienced a higher increase than average for both the United States and Texas (see chart below). HSR 7 is one of the eight health service regions of the Department of State Health Services, serving a 30 county area in Central Texas, including Williamson County. The pertussis epidemic is one of the most important challenges facing public health departments.
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Pertussis vaccines are highly effective, strongly recommended, and save many infant lives every year. Though the protection they offer lasts only a few years, they are given so that immunity lasts through childhood, the time of greatest exposure and greatest risk.[7] The immunizations are given in combination with tetanus and diphtheria immunizations, at ages 2, 4, and 6 months, and later at 15–18 months and 4–6 years and 11 years.
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Pertussis can occur at any age. However, infants and young children, particularly those who are not immunized or who are not yet fully immunized against pertussis, are at highest risk for getting severe whooping cough and suffering from serious, potentially life-threatening complications.
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Pertussis is primarily spread when infected people cough or sneeze, expelling droplets that contain Bordetella pertussis bacteria. Older siblings or adults who may be harboring the bacteria in their nose and throat can infect an infant.
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For decades, the pertussis vaccine has been given in combination with vaccines against diphtheria and tetanus. The combination is known as the DTP vaccine. Recently, infants have been able to receive a vaccine that combines the DTP vaccine with the vaccine against Haemophilus influenzae type b meningitis (Hib). This vaccine is called DTPH. The diphtheria-tetanus-pertussis vaccine using acellular pertussis is known as DTaP. The diphtheria-tetanus-pertussis vaccination is given in five doses: at 2, 4, 6, 12-18 months and 4-6 years of age.
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Three acellular pertussis vaccines (Tripedia® and Infanrix™ for the first four doses and ACEL-IMUNE® for all five doses) are licensed for the diphtheria, tetanus, and pertussis vaccination series. The Food and Drug Administration (FDA) has not approved Tripedia® or Infanrix™ as the fifth dose among persons who have received only Tripedia® or only Infanrix™ for the first four doses in the vaccination series, because data are insufficient to evaluate their safety in this situation. However, such data should be available before infants vaccinated with four doses of these vaccines require a fifth dose at age 4 to 6 years. TriHIBit™ (ActHIB® reconstituted with Tripedia®) is licensed only for the fourth dose of the vaccination series, and is not licensed for the first three doses. TriHIBit™ can be used for the fourth dose following three doses of either diphtheria, tetanus, and acellular pertussis or whole-cell diphtheria, tetanus, and pertussis and a primary series of any Haemophilus influenza type B vaccine.
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