Texas hospitals battles whooping cough Epidemic
Pastor Dale Morgan
Texas hospitals battles whooping cough Epidemic*
Texas Children's inoculating parents in an effort to halt spread of illness
By TODD ACKERMAN
Houston Chronicle
With whooping cough at its highest levels since the 1950s, Texas
Children's Hospital has launched a program to protect babies from the
life-threatening infection by immunizing family members.
Hospital officials announced Thursday they have begun administering the
"cocoon strategy" — booster shots for parents who often unknowingly
spread the infection — at Houston's Ben Taub General Hospital.
"With this program, we can prevent whooping cough in our most vulnerable
population — infants less than 6 months," said Dr. Carol Baker,
executive director of Texas Children's Center for Vaccine Awareness and
Research. "Whooping cough can be difficult to diagnose in adults when
it's mild, but it's just as transmissible and potentially lethal to
their babies."
Baker said the program is the first in the nation to implement the
strategy recommended by the federal Centers for Disease Control and
Prevention in 2006.
The recommendation followed the Food and Drug Administration's 2005
approval of the booster shot for people 11 to 64. The original series of
the vaccine eventually starts wearing out around age 10.
More than 25,000 cases of the infection were reported in the United
States in both 2004 and 2005, at least three times more than annual
amounts reported in the '90s and at least six times more than in the '80s.
Texas Children's officials said they're unsure what accounts for the
spike but speculated waning immunity and increased crowding, travel and
immigration are some of the factors.
The majority of the cases in Harris County involve Hispanics, Baker said.
Public health threat
Whooping cough, also known as pertussis, is a highly contagious
bacterial infection of the respiratory system that causes 40 to 80
infant deaths a year in the U.S. It is the only common
vaccine-preventable disease in the U.S. that's on the rise.
Before the development of a vaccine, whooping cough was a major public
health threat, particularly from the 1920s to the '40s, when it infected
as many as 265,000 Americans a year and killed as many as 9,000 a year,
said Dr. Mary Healy, director of the Texas Children's cocoon-strategy
program.
Since the vaccine, she said, its annual incidence dropped to around
30,000 in the 1950s and as low as about 1,000 in 1976. It began creeping
up in the 1980s and 1990s.
The Texas Children's program will administer the booster shot, Tdap,
free of charge to 5,800 families the first year, a projected total of
about 17,000 shots. The shot typically costs $35.
Babies are especially vulnerable to the infection because they don't
have full protection against it until they're 6 months old, when they
receive the last of three shots.
The infection, characterized in infants by episodes of rapid coughing
followed by a high-pitched "whoop" sound, is particularly hard on
babies' fragile, developing lungs and can lead to failure to breathe,
pneumonia and swelling of the brain.
More than 75 percent of infants who get whooping cough are infected by
other members in their household, often unaware they have the disease.
According to the CDC, the infection is passed on by mothers 33 percent
of the time, fathers 16 percent and siblings 19 percent.
In the case of 4-week-old Haleigh Throgmorton, it was her father. He
thought he had just picked up a cold, but it soon became apparent he had
spread whooping cough to his daughter. Two weeks later, Haleigh died in
an intensive care unit.
"We had no clue," said her mother, Jerri-Lynn Throgmorton, of Panhandle,
about 30 miles northeast of Amarillo. "We didn't know whooping cough was
still around. It took two hospital tests — the first came back negative
— to confirm it."
Throgmorton, whose husband has since traveled frequently to Austin to
testify for mandatory vaccination, said the Texas Children's program
"sounds wonderful. I wish they'd had a program like it here when Haleigh
was born."
The cocoon-strategy program will be administered by the Center for
Vaccine Awareness and Research, whose creation was announced
simultaneously Thursday. The center's Web site, www.vaccine.texas
childrens.org, provides up-to-date information about all vaccines and
ongoing research.
State lags in immunizations
The cocoon-strategy program was funded by a joint grant from the
Methodist Hospital and Baylor College of Medicine. The grant is part of
an initiative that Texas Attorney General Greg Abbott brokered in 2005
to end the acrimonious split of the one-time partners.
There are no Texas-specific figures for whooping cough vaccination, but
the state generally lags behind national immunization averages. Noting
that nearly one-third of Houston's children under 3 aren't vaccinated,
Baker said that number is a good marker for the whooping cough vaccine
specifically.
Baker said Texas Children's will implement the program when it gets in
the maternity business in 2010. She said she hopes other hospitals do as
well.
"You're going to have natural cycles, waves during which disease crest
and fall," said Healy, also a professor of pediatrics at Baylor. "But
the take-home message from the current numbers is, we're seeing an
epidemic."