Health Care

October 6, 2013

Whooping cough on the rise in South Carolina

Effective vaccinations introduced in the 1950s greatly reduced the incidence of whooping cough, but the disease never was eradicated. In fact, whooping cough cases in the U.S. have risen dramatically in recent years.

Felicia Dube has a cautionary and important tale to tell about a disease few people worry about. It hurts every time, but she keeps telling it.

Effective vaccinations introduced in the 1950s greatly reduced the incidence of whooping cough, but the disease never was eradicated. In fact, whooping cough cases in the U.S. have risen dramatically in recent years.

Still, deaths are rare. Only 26 were recorded in the U.S. in 2010, according to federal health statistics. One of those was Dube’s infant son Carter. She turned that heart-wrenching experience into a mission to raise awareness about the disease.

“God gave me Carter’s story to do something with it. He didn’t give it to me to keep to myself,” said Dube, who lives in Lancaster. “Every time I tell his story and it changes one person’s mind, I think his wings got a little bit bigger.”

The need for that education effort was heightened by a whooping cough outbreak in the Upstate this summer. State health officials put out warnings after cases were diagnosed in Anderson and Clemson.

About 41,000 cases of whooping cough – officially known as pertussis – were reported in 2012 in the U.S. Eighteen of those patients died, the vast majority less than one year old, according to the March of Dimes.

In South Carolina, the number of whooping cough cases went from 43 per year from 1999-2002 to 260 per year from 2009-2012, according to state health records.

Pertussis is a highly contagious bacterial disease that is completely preventable by vaccination, according to Dr. Edward McCabe, a pediatrician and child medical officer for the March of Dimes. It is prevented by the Tdap vaccine in children, who should receive five doses during childhood. But the immunity wears off, McCabe said. Adults often are unaware they also should get a Tdap booster, especially if they work with children or have young children of their own.

Dube never thought about whether the adults in her extended family had received a booster when Carter, her second son, was born in December 2009.

Carter was a healthy 6-pound, 6-ounce baby. A few days after his five-week check-up, Carter became fussy and agitated and developed a low-grade fever. They took Carter to Levine Children’s Hospital in Charlotte, where he was tested for respiratory syncytial virus and influenza.

“On the second day, someone said ‘whooping cough’ and I said to my husband, ‘I don’t know anyone who gets whooping cough anymore,’” Dube said.

It wasn’t until three days after Carter started feeling bad that he suffered his first coughing fit, but it was violent enough that he turned blue, his mother said.

“From that point on, he really went downhill,” Dube said. “He was agitated times 10.”

The next day, he was moved to the pediatric intensive care unit and placed on a respirator. One week after being admitted to the hospital, doctors suggested that Carter needed to go on a heart and lung bypass machine.

Dube’s older son Zachary, who was 10 at the time, had not been allowed to visit his brother in the hospital because it was flu season and children were not allowed to visit patients. But Dube and her husband, Daryl, convinced doctors to let Zachary visit Carter before he went on the heart and lung machine.

“I just didn’t know how to explain the heart and lung bypass (to Zachary),” Dube said. “As a parent, you’re just not prepared to see your baby with all these tubes and wires.”

Doctors were working their way through five medications trying to fight the infection. The fifth medication was their last option, but it came with the risk of brain damage and it tinted Carter’s skin blue. He showed signs of improvement for about 90 minutes, then crashed again.

The Dubes called in their relatives and their minister. Then they each spent a few minutes alone with their son.

“I told him if he was tired he could go,” Felicia said. “It was OK, and we would see him again someday.”

Carter died Jan. 28, 2010, nine days after he was admitted to the hospital. The next day, they learned the tests confirmed he had pertussis.

Dube assumes that Carter was exposed to pertussis by someone who visited their home or someone in the pediatrician’s office. “It wasn’t like I was on a mission to find out who in my family had it,” Dube said.

But she did turn her energy toward raising awareness about the importance of the adult Tdap booster.

A few months after Carter’s death, she heard NASCAR racer Jeff Gordon speaking on the radio on behalf of the Sounds of Pertussis campaign, a collaborative effort between the March of Dimes and vaccine manufacturer Sanofi Pasteur to raise awareness of the importance of vaccination. She wrote to the campaign to tell Carter’s story, and has been telling it ever since.

And when she became pregnant again with her daughter Brennan, now 2, she made sure anyone who came to visit was up-to-date on their pertussis vaccines.

“It’s so important, and it’s so simple,” she said. “I wish there had been someone speaking up (when Carter was born) because I didn’t know. I felt I had done my job as a parent, but I dropped the ball. I didn’t know.”

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