If you’re reading this and you are under the age of 30, there’s a good chance that you have no idea what whooping cough is. Even those who have been around since the 70s might struggle to remember someone that they know who’s had the disease.
That’s because whooping cough (or pertussis), is a vaccine-preventable disease that was largely eliminated by the introduction and widespread use of the vaccine in the 60s and 70s. By the late 90s, rates had dropped from hundreds of thousands of cases a year to almost none, and the disease was well on its way to being eradicated completely.
Sadly, that didn’t happen.
But before I go into that, a quick refresher.
Coughing For Days
Whooping cough is a nasty disease caused by the bacteria Bordetella pertussis, and is characterized by its distinctive cough. And when I say ‘distinctive’, I mean really, really nasty: a common symptom of whooping cough is people coughing so hard that they throw up, and without treatment a case can last for weeks or even months.
Not very nice at all.
The good news about whooping cough is that healthy adults like me are at very low risk from it. If you catch the disease, chances are you’ll end up on with flu-like symptoms (and that nasty cough), but a course of antibiotics and a few days of bed rest are usually all that’s needed.
The bad news? Babies aren’t so lucky.
In kids who are too young to be vaccinated, whooping cough can kill.
The even worse news is that, after dropping to almost nothing for decades, whooping cough rates have climbed steadily in the last 20 years. Whilst many of these new cases are in adults there are still many young kids who catch this nasty disease.
Waxing and Waning
There are a bunch of reasons why whooping cough has reemerged. The big one is that we switched from a ‘live’ vaccine that contained bacterial cells to the acellular vaccine in the early 90s, because the acellular vaccine was thought to be safer than the original one.
The problem is that the very thing that makes the acellular vaccine safer — your body is less likely to have a major reaction to it — also means that it doesn’t provide the same level of immunity as the cellular one does. Whilst a single dose of the whooping cough vaccine will still provide you with really good protection against getting the disease, after 8–10 years your level of protection starts to wane.
This bit is important, so I’m going to bold it:
The waning protection doesn’t mean that you aren’t protected at all. Even decades after vaccination, someone who has been vaccinated is less likely to get the disease, and will likely be much less sick if they do catch it than someone who hasn’t been vaccinated at all. This is true even for a single dose of the vaccination.
What waning protection does mean is that you are more likely have a minor infection — which you might not even notice — and pass this on to someone who is really at risk.
Like a newborn baby.
“So how do we protect infants?”, you ask?
Cocooning is an amazing public health practice that has been developed to provide a safe environment for newborns. It stops them from getting serious diseases by keeping them away from anyone who might have the disease.
Basically, it means vaccinating everyone who might have contact with the vulnerable infant. Parents, grandparents, siblings, aunts, uncles, friends, that guy who hangs around your house sometimes; anyone who could possibly pass the bacteria on to the child.
We also vaccinate pregnant mothers. Cocooning reduces the risk of contacts giving whooping cough to a baby, but vaccination during pregnancy gives a significant boost to the infant’s immune system. This means that not only are they significantly less likely to catch the disease, but if they do catch it they will be less likely to get dangerously sick.
When done correctly, maternal vaccination and cocooning reduce the risk of a newborn catching whooping cough to almost nothing. The big downside is that it’s pretty expensive, but many states in the US and elsewhere offer these programs because the benefits are so massive. Not only is whooping cough really dangerous for babies, it’s also seriously expensive for the health system, with each newborn infection costing thousands of dollars to treat.
So what does this mean to you? If you never see any babies, not all that much. You’re recommended to get a whooping cough booster once every ten years or so anyway, but if you aren’t due for it then there’s no reason to run to your GP.
Whooping cough is nasty, but for your average adult it’s not that big of an issue.
But if you are likely to see a newborn any time in the next few months — particularly if that newborn if going to be yours — you should probably go have a talk to your GP about getting vaccinated.
Not only is it good for your health, but you might save that baby’s life.