Pertussis
Click on the photo above to open the Pertussis page from the Vaccine-Preventable Diseases eBook!The Disease
Also known as whooping cough, pertussis is a highly contagious disease. It is also the most common vaccine-preventable disease in the U.S. This disease, which spreads easily through coughing and sneezing, usually starts with cold-like symptoms and maybe a mild cough or fever. (People with pertussis are most contagious up to about 2 weeks after the cough begins.) After 1 to 2 weeks, violent and rapid coughing with a loud "whooping" sound, may occur. (Watch a video of a child with whooping cough.)
Pertussis can cause serious and sometimes life-threatening complications, such as pneumonia and apnea (slowed or stopped breathing), in infants and young children, especially those who are not fully vaccinated. Teens and adults can also get complications from pertussis, but they are usually less serious than in infants and young children. Complications in teens and adults, such as passing out or fracturing a rib, are often caused by the cough itself.
In adolescents and adults, pertussis often appears to be just a bad cold with symptoms such as a prolonged cough with no "whooping" sounds. People can spread pertussis to babies without even knowing they are sick because the illness may be so mild. Many infants who get pertussis catch it from their parents or older brothers and sisters. In up to 83% of infant pertussis cases, babies caught the disease from a family member, usually a parent. Most unvaccinated children living with a family member with pertussis will contract the disease.
The Statistics and Outbreaks
Ninety-percent (90%) of pertussis-associated deaths have been among babies less than 1 year old. In infants younger than 1 year of age who get pertussis, about half are hospitalized. Of those infants who are hospitalized with pertussis about 1 in 4 get pneumonia; 1 or 2 in 100 will have convulsions; two thirds will have apnea (slowed or stopped breathing); 1 in 300 will have encephalopathy (disease of the brain) ; and 1 or 2 in 100 will die.
Large outbreaks of pertussis have been occurring in the U.S. in recent years. In 2010, more than 27,000 cases were reported and by 2012 that number rose to more than 48,000 cases, marking a 58-year high. In 2013, the number of cases was 28,639, and in 2014, 28,660 pertussis cases were reported to the CDC. Outbreaks of the disease continue in 2015. There are several reasons that help explain why there have been more cases of pertussis over the last few years including increased awareness, improved diagnostic tests, better reporting, more circulation of the bacteria, and waning immunity. In addition, many children fail to receive all of the recommended doses of the vaccine and remain vulnerable to the disease.
Pertussis vaccines are effective, but not perfect. They typically offer high levels of protection within the first 2 years of getting vaccinated, but then protection declines over time. Although the vaccine isn't perfect, getting the pertussis vaccine is always a better choice than not getting vaccinated against pertussis. Vaccinated children who get pertussis usually have a milder case of the disease and reduced risk of serious complications. They are also less likely to spread the pertussis than unvaccinated children.
The Vaccine
The childhood vaccine that protects against pertussis is called DTaP (combined diphtheria, tetanus and pertussis vaccine).For the best protection against pertussis children should receive all five doses of the DTaP vaccine at ages 2 months, 4 months, 6 months, between 15-18 months and between 4-6 years.
The pertussis booster vaccine for adolescents and adults is called Tdap (combined tetanus, diphtheria and pertussis vaccine). Preteens should get one dose of the Tdap vaccine at 11 or 12 years old. Adults 19 years of age and older who didn't get Tdap as a preteen or teen should also get one dose of Tdap.
According to the CDC, children who haven't received their five doses of DTaP vaccines are at least 8 times more likely to get pertussis than children who received all five recommended doses of DTaP.
Women should be vaccinated with Tdap during every pregnancy, preferably in the third trimester (between the 27th and 36th week). By getting vaccinated during pregnancy, mothers build antibodies that are transferred to the newborn, providing protection against pertussis before the baby can get their first dose of DTaP vaccine at 2 months old. Tdap also protects mothers during delivery, which makes them less likely to transmit pertussis to their babies. This recommendation is supported by The American College of Obstetricians and Gynecologists.
If not vaccinated during pregnancy, new mothers should receive the Tdap vaccine postpartum before leaving the hospital or birthing center. In addition, all family members and caregivers of new infants should also get vaccinated with Tdap. If possible, people should receive the vaccine at least 2 weeks before beginning close contact with the infant. The strategy of protecting infants from disease by vaccinating pregnant women and vaccinating those people who will be around the new baby is called "cocooning."
Additional Resources
- View the recommended immunization schedules for children, teens and adults.
- Pertussis (DTaP) Vaccine Information Sheet
- Pertussis (Tdap) Vaccine Information Sheet
- Send an eCard about Pertussis Vaccination
- Download Pertussis Posters from ECBT
- Pertussis: Protect Your Loved Ones (Fact Sheet)
- CDC Pertussis Webpage (information available in English and Espanol)
- ACIP Vaccine Recommendations for Tdap/Td
- Where Can I Get Vaccinated with Tdap?
- Immunization Information for OB-GYNs and Their Patients