The California Department of Public Health recently reported the first death of an infant from pertussis since 2010, the last time the disease peaked in the state.  That year, pertussis reached epidemic levels with more than 9,100 cases and 10 deaths in California alone.

Whooping cough rates typically rise and fall in a three- to five-year cycle. According to public health officials, pertussis cases had been declining since they peaked in 2010, but began to go up again in mid-2013. The state's preliminary case count for 2013 is 2,372, up from just 1,022 in 2012.

It is too soon to know how pertussis cases will trend in 2014, but the rising rates highlight the importance of vaccination.

State public health officials remind physicians that the best way to protect infants against fatal or severe pertussis infection is to vaccinate pregnant women with Tdap during every pregnancy. Vaccinated pregnant women develop antibodies to pertussis that are passed to the fetus and may protect young infants until they are old enough to be vaccinated at six weeks of age. To maximize the maternal antibody response and passive antibody transfer to the infant, optimal timing for Tdap administration is between 27 and 36 weeks of gestation. In addition to providing pertussis antibodies to the infant, the mother herself will be protected and less likely to become infected and transmit pertussis to her infant.

Vaccination during pregnancy is highly preferred over postpartum vaccination. However, if a woman is not vaccinated prior to giving birth, it is recommended that she receive the vaccine before hospital discharge (breastfeeding is not a contraindication). In addition the other family members and close contacts of infants who have not received Tdap, should be vaccinated at least 2 weeks prior to any contact with the infant.

Babies can get their first dose of the pertussis vaccine at 6 weeks of age, and should have three doses by the time they are 6 months old, according to the Department of Public Health. Children should also receive booster shot in their second year, before kindergarten and at 11-12 years of age. Adults and teens who never received a vaccine during their preteen years are also encouraged to get vaccinated.

For more information and guidelines on pertussis vaccination, see the California Department of Public Health website.

Contact: Scott Clark, (916) 551-2887, sclark@cmadocs.org.