December 15, 2010   We would like to provide you with an update regarding the Pertussis outbreak.   The outbreak of Pertussis (Whooping Cough) began in California this year.  As of November 30th, 2010, there are 7,297 cases.  This is the most cases reported in 63 years.   Ten deaths have been reported in infants less than 3 months of age.   Of those hospitalized, 75% were infants less than 6 months of age.   While it appears that the number of cases in California may be leveling off, there are a host of other states; including New York, where cases are climbing.  The symptoms of pertussis are best described in this CDC link:  Symptoms of Pertussis.   Pertussis causes a characteristic cough:   Sounds of Pertussis.  Approximately 75% of infants are infected by a household member.   Infants do not get enough protection until 6 months of age, so there have been very recent changes regarding recommendations to be vaccinated for pertussis.   The CDC and Four Seasons Pediatrics recommend that all of the following groups be vaccinated as soon as possible:

• All adolescents age 11-18 (as required by New York State Law for those when they turn 11.  Your 11 year old would have received a shot if they turned 11 in the last 4 years.  In addition, we have been recommending it to all other adolescents for 2 years now)
• All adults age 19-64 should receive a dose of Tdap in place of one normal tetanus shot (called Td). 
• All adults age 19-64 who have not received a dose of Tdap – or for whom the status is unknown – should be immunized as soon as possible, REGARDLESS of the interval since the last normal tetanus shot (Td)
• The newest recommendation is that all adults aged 65 years and older who have or who anticipate having close contact with and infant aged younger than 12 months (grandparent, CHILD DAYCARE WORKERS, and health care providers) should receive a single dose of Tdap to protect against pertussis
• For those children aged 7-10 with an incomplete or unknown pertussis vaccine history should also get a dose of Tdap. 

Dr. Miller Comment:

We urge you to follow the above recommendations as soon as possible.  Holidays are a time we all have wonderful memories and family gatherings.  Lets do all we can to not make Pertussis one of the memories.   If you are of child bearing age, it is very important to pay attention to this issue.  If you have a child under 12 months in daycare, I would ask the daycare provider if all staff have been vaccinated.  They may not be aware of the new recommendations, so feel free to share this newsletter.   Finally, a recent study showed that infants born to women who received the Tdap during pregnancy had higher infant protection to Pertussis for the first few months of life than infants born to unvaccinated women.  We may see this recommendation implemented soon.