Whooping cough cases are surging across the U.S. One mom whose infant daughter died of the disease is now raising awareness about vaccinations during pregnancy.
A Detroit mom who lost her newborn baby to whooping cough is sounding the alarm for other parents.
"Watching my daughter die was horrible," said Veronica McNally, whose daughter Francesca died from the disease when she was just 3 months old.
Once considered a near-extinct childhood disease, reported cases of pertussis, or whooping cough, have reached levels unseen since the 1950s. Despite this, a recent University of Michigan study found that 61 percent of adults don't know when they received their last immunization.
Because vaccinations can wear off over time, that lack of knowledge can be harmful for infants, as most pertussis deaths occur in babies under 3 months.
Health officials hope to reverse that trend by protecting infants before they're born. Since 2011, the Centers for Disease Control and Prevention have recommended a Tdap (tetanus, diphtheria and pertussis) booster for pregnant women and anyone who will have contact with babies and young children. In February 2013, the CDC Advisory Committee on Immunization Practices strengthened that guideline, encouraging Tdap administration during each pregnancy, regardless of previous Tdap history. The American Congress of Obstetricians and Gynecologists supports the latest recommendations.
"By vaccinating the mom, there's the trans-placental transfer of protection to the infant at birth," said Tami Skoff, a CDC epidemiologist.
For McNally, a metro Detroit mother, that advice came too late.
As she prepared to give birth to her third child in February 2012, an admission intake nurse at the hospital asked if she wanted a Tdap shot. McNally says she didn't know anything about the vaccine or its importance and wasn't given any advice from the nurse about why she should receive it. McNally declined the vaccination and a few hours later delivered a healthy baby girl, Francesca Marie.
A few months later, McNally contracted pertussis. Her 3-year-old son Stephen also caught it, as did Francesca. As McNally and her husband Sean sought treatment for their family, incorrect diagnoses of everyone's symptoms — croup, respiratory syncytial virus, influenza — from multiple doctors delayed proper treatment for Francesca's worsening cough. When doctors finally recognized Francesca's pertussis, it was too late. She died nine days after her symptoms started at just 12 weeks old.
"It's critical to understand these risks," McNally said. "These diseases are real."
DELAYED TREATMENT CAN BE FATAL
Today, the McNallys work to educate others about infant pertussis and the importance of vaccination through the Franny Strong Foundation, named for their daughter.
"This is my tribute to her," McNally said. "So many lives will be saved that we'll never know about because of this."
In 2012, the CDC received more than 41,000 pertussis reports, the most since 1955. Preliminary data reported 18 deaths last year, the majority in infants under 3 months. As of June 20, the CDC had received reports of three infant deaths and close to 8,000 whooping cough cases throughout the country.
Infants don't receive a pertussis vaccination until they're 2 months old, although full immunity isn't reached until the final childhood vaccination between 15 and 18 months of age.
That's why it's important, health officials say, for women to be vaccinated during pregnancy, ideally between 27 and 36 weeks. A mother who isn't immunized while pregnant and has never received Tdap in the past should get the vaccine immediately postpartum.
Waning immunity is among the reasons for the rise, the CDC says, as vaccinations more than 10 years old might not be effective today. There is also concern that the current version of the vaccine, which was introduced in 1997 because it causes fewer side effects, may wear off more quickly than the older version — perhaps in just a few years. A Tdap booster is recommended for all adults and teens, especially those who will be around infants, to create a "cocoon" of protection for the baby, along with the mother's prenatal immunization.
A contagious respiratory infection, pertussis can last 10 weeks or more. In adolescents and adults, it initially resembles a cold, with symptoms including a slight cough, runny nose and maybe a mild fever. Coughing can grow stronger in intensity after a few weeks, and a "whooping" sound is often heard as sufferers attempt to get air back into the lungs. In infants, the cough isn't always heard, and the breathing disruption, or apnea, might not be recognized as a pertussis symptom.
Delayed treatment can prove fatal, as it was for Francesca McNally. Her mother wants to ensure no other family experiences such a loss.
"I'm still not back to normal," said McNally, who's due to give birth again this week. "I live with the fact everyday that Francesca's death was preventable."
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