The California Department of Public Health (CDPH) Director and State Health Officer has declared a pertussis epidemic and is urging the healthcare community to protect young infants who are most vulnerable to complications and death from pertussis. As of June 24, 2014, 4,558 pertussis cases had been reported to CDPH, more than the number reported in all of 2013. Locally, there have been 21 cases of pertussis since January, 2014 with 7 of these cases reported in June. There are three additional cases currently under investigation.
Infants too young to be fully immunized are most likely to be hospitalized or die from pertussis. Of the cases reported so far this year in California, 177 cases were infants <4 months of age; 89 (50%) of whom were hospitalized. Tragically, 3 infants in California, all too young to be vaccinated, have died from pertussis in 2014. The Santa Barbara County Health Officer, Dr. Charity Thoman and CDPH recommend that prenatal providers follow the federal Advisory Committee on Immunization Practices (ACIP), American College of Obstetricians and Gynecologists (ACOG), and American Academy of Family Physicians (AAFP) recommendations to immunize all pregnant women between 27 and 36 weeks gestation with Tdap vaccine during each pregnancy, regardless of the number of prior doses of Tdap previously received, to maximize protection of the newborn infant. This strategy provides protection to the infant from maternal antibodies transferred from the vaccinated mother to the fetus, helping to protect infants until they are old enough to be vaccinated.
Infants should be vaccinated against pertussis with the DTaP vaccine without delay. The first dose is routinely recommended at 2 months of age but can be given as early as 6 weeks of age. Even one dose of DTaP vaccine may offer protection against fatal pertussis infection. Children need five doses of DTaP vaccine by kindergarten (ages 4 – 6 years). A Tdap booster is recommended for adolescents at age 11-12 years. Also, adults who haven’t yet received Tdap should receive it, especially if they are in contact with infants or if they are healthcare workers who may have contact with infants or pregnant women.
It is important that patients consistently receive clear information regarding Tdap/DTaP immunization. By coordinating efforts across the state, we can increase immunization of pregnant women during the third trimester and young infants.
Please continue to report suspect, probable and confirmed pertussis cases via the CalREDIE Provider Portal. You may also visit our Immunization Program website at: www.sbcphd.org/iz or contact the Disease Control Program 24/7 at (805) 681-5280 or our website at www.sbcphd.org/dcp