What did we learn from the 2010 California whooping cough epidemic?

July 19, 2012, Elsevier

Because whooping cough (pertussis) is almost as contagious as measles (affecting ~12-17 individuals with each case), clinicians are required to report cases of this bacterial respiratory tract infection to the state's department of public health. In 2010, California had the highest number of cases of whooping cough in 60 years. A new study scheduled for publication in The Journal of Pediatrics describes the 2010 whooping cough epidemic and details strategies to decrease the incidence of this infection.

Kathleen Winter, MPH, and colleagues from the California Department of Public Health (CDPH) evaluated 9,154 cases of whooping cough with onset between January 1 and December 31, 2010; 809 cases were hospitalized and 10 resulted in death. All deaths and most of the hospitalized cases (62%) were in infants less than 3 months of age, and infants less than 6 months of age had the highest disease rates. In the population aged less than 6 months, had the highest incidence of whooping cough. However, in children and adolescents 1-18 years of age, Whites had the highest incidence.

It is recommended that infants should receive 4 doses of DTaP (, tetanus, and pertussis) vaccine by 18 months of age, and children should receive whooping cough "booster" doses at 4-6 years of age (DTaP) and 11-18 years of age (Tdap). Adults are also encouraged to receive the Tdap booster because immunity from both the disease and the vaccine wanes over time. The number of cases of whooping cough was elevated in pre-adolescents, even when they are fully vaccinated, indicating that protection from the 5-dose DTaP series may wane before the Tdap booster is given. However, the authors believe that the decrease in cases of 11-14 year olds suggests that Tdap is effective for adolescents.

In response to the sharp increase of cases in 2010, CDPH implemented a to distribute educational materials to and the public to stress the importance of rapid diagnosis and treatment, especially in young infants, recommend vaccination for adults older than 64 years of age, under-immunized children 7-9 years old, and pregnant women, and provide free Tdap booster vaccines to hospitals, community health centers, and Native American health centers for pregnant and postpartum women and other infant contacts. To decrease the occurrence of whooping cough in infants who are too young to be vaccinated, it is important to immunize household and family members who will be in close contact with the baby (a strategy known as "cocooning") and increase the immunity of the population as a whole to decrease infants' exposure to pertussis.

Prior to the epidemic in 2010, only 23% of California birth hospitals had policies to offer Tdap to postpartum women. In 2011, the Centers for Disease Control and Prevention recognized the extreme vulnerability of young infants and recommended universal Tdap immunization for pregnant women (after the 20th week of gestation) who previously had not received Tdap. According to Ms. Winter, "In the absence of better vaccines, it is imperative that strategies to protect young infants directly, such as maternal vaccination during pregnancy, be evaluated for effectiveness. In addition, it is critical that providers continue to be vigilant and promptly diagnose and treat young infants with ."

Explore further: Panel: All adults should get whooping cough shots

More information: “California Pertussis Epidemic, 2010” by Kathleen Winter, MPH, Kathleen Harriman, PhD, MPH, RN, Jennifer Zipprich, PhD, Robert Schechter, MD, John Talarico, DO, MPH, James Watt, MD, MPH, and Gilberto Chavez, MD, appears in The Journal of Pediatrics, DOI 10.1016/j.jpeds.2012.05.041

Related Stories

Panel: All adults should get whooping cough shots

February 22, 2012
A federal advisory panel wants all U.S. adults to get vaccinated against whooping cough.

Recommended for you

Baby brains help infants figure it out before they try it out

January 17, 2018
Babies often amaze their parents when they seemingly learn new skills overnight—how to walk, for example. But their brains were probably prepping for those tasks long before their first steps occurred, according to researchers.

NeuroNext biomarker study explores natural history of infantile-onset SMA

January 9, 2018
Research led by The Ohio State University Wexner Medical Center to define the natural history of infantile-onset spinal muscular atrophy (SMA) has been "critical" to accelerate the development of effective therapies and hasten ...

No link between childhood lead levels, later criminality

December 27, 2017
(HealthDay)— Exposure to higher levels of lead during early childhood can affect neurological development—but does that mean affected kids are doomed to delinquency?

Early puberty in girls may take mental health toll

December 26, 2017
(HealthDay)—A girl who gets her first menstrual period early in life—possibly as young as 7—has a greater risk for developing depression and antisocial behaviors that last at least into her 20s, a new study suggests.

Technology not taking over children's lives despite screen-time increase

December 21, 2017
With children spending increasing amounts of time on screen-based devices, there is a common perception that technology is taking over their lives, to the detriment and exclusion of other activities. However, new Oxford University ...

Higher blood sugar in early pregnancy raises baby's heart-defect risk

December 15, 2017
Higher blood sugar early in pregnancy raises the baby's risk of a congenital heart defect, even among mothers who do not have diabetes, according to a study led by researchers at the Stanford University School of Medicine.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.