2. Child Care Provider Parents Siblings GrandparentsHealthcare Worker

3. PERTUSSIS IS ONE OF THE FEW REMAINING POORLY CONTROLLED INFECTIOUS DISEASES FOR WHICH CHILDREN ARE ROUTINELY IMMUNIZED. Pertussis (AKA: Whooping Cough)

4. Disease Highest Case Count during 20 th Century 2008* Percent Decrease Measles88,000 (1958)0100% Rubella8,408 (1970)0100% CRS12 (1974)0100% Mumps32,939 (1950)2399.9% Pertussis21,588 (1947)188291.2% Diphtheria1,544 (1946)0100% Tetanus55 (1954)0100% Polio (paralytic)2,778 (1950)0100%

5.  Increasing nationwide since 1980  More significant in Texas in the past decade  Particularly evident in adolescent and adult populations

6. * Provisional as of March 27, 2009

8. Waning immunity in adolescent and adult populations Waning expected 5-10 years after administration of childhood vaccine shots

9. Percentage of Texas Pertussis Cases by Age Group

10. Pertussis is on the rise due to waning immunity in the adult and adolescent populations Nearly 75% of the time, a family member is the source of pertussis disease in infants. It is crucial that adolescents and adults follow the CDC recommendations to receive a Tdap booster shot to prevent pertussis. These recommendations can be found at: http://www.cdc.gov/vaccines/vpd -vac/combo-vaccines/DTaP-Td- DT/Tdap.htm http://www.cdc.gov/vaccines/vpd -vac/combo-vaccines/DTaP-Td- DT/Tdap.htm

11. In adults, symptoms often resemble a cold Pertussis is most contagious BEFORE coughing begins Parents may not be aware that they have pertussis or are spreading this disease to their babies. Disease is more severe for infants

12.  65% of cases in kids under 1 year of age result in hospitalization.  Nationally, there are 10-20 deaths from pertussis reported each year.  In 2008, there were 4 deaths in Texas.  Duration of cough as a result of this disease averages 36 days, but can last up to 60 days.  Pertussis can cause apnea, malnutrition, and seizures in infants.

13. VIDEO: What Every Parent Needs to Know -- Protecting Your Baby from Pertussis at http://www.texmed.org/Template.aspx?id=2656http://www.texmed.org/Template.aspx?id=2656

14.  A single dose of Tdap for adults 19-64 years of age to replace the next booster dose of tetanus and diphtheria toxoids vaccine (Td).  Adolescents should receive their first Tdap shot after their 11th birthday.  Tdap is recommended for all adolescents and adults. It is particularly important to ensure that close contacts and caregivers of infants receive a Tdap booster.  Adults who have or who anticipate having close contact with an infant aged <12 months (e.g., parents, grandparents aged <65 years, child-care providers, and healthcare personnel) should receive a single dose of Tdap to reduce the risk for transmitting pertussis.  An interval of 2 years from the last Td is suggested; but shorter intervals can be used.  When possible, women should receive Tdap before becoming pregnant.  Women who have not previously received Tdap should receive a dose of Tdap in the immediate postpartum period.

15.  ACIP recommendations are recent  Pertussis is a relatively unknown disease, not considered a significant health threat  Competing interests New child with significant needs  Lack of access

16.  Federal Stimulus Funding  Efforts by NICUs to offer mothers, and in some cases fathers Tdap in the post-partum period  Increase tetanus (Td) requirements in ERs to Tdap, using Tdap for wound prophylaxis  Make sure healthcare workers are vaccinated  New School Recommendations in Texas  Educate parents or adult caregivers at prenatal visits or newborn appointment with pediatricians on the importance for all close contacts of the baby to be vaccinated

18. TPS Website: http://www.txpeds.org/extras/cocooning.php My Contact Info: laura.sally@txeds.org 512-370-1509