The cocoon effect

Paige Tomcho was two days past giving birth to her son, Briar, when she started to cough. "I thought it was a cold or allergies," recalls Tomcho, an osteopathic family physician in Waxhaw, North Carolina. A week later, she was still coughing and congested and so was Briar, who developed pneumonia. After he got antibiotics, the baby's lungs cleared up, but he and his mom kept on hacking. Tomcho's cough got so bad that she began throwing up. Soon after, Briar started feeding less, became dehydrated, and his lips turned blue, so Tomcho took him back to the emergency room.

"That's when we learned that we both had whooping cough," she says. Doctors immediately put mom and baby on heavy-duty antibiotics.

Whooping cough, or pertussis, has been making a disturbing comeback over the past two decades, possibly because immunity starts to wane before the teen years. Because of that, in 2006 the CDC began recommending that teens and adults replace their next ten-year tetanus-diphtheria (Td) booster with a tetanus-diphtheria-acellular pertussis (Tdap) booster. Unfortunately, fewer than 2 percent of adults have followed through, and cases have continued to rise.

While pertussis can be miserable for a grown-up, it can be devastating for a baby, says pediatric infectious-disease specialist Mary Healy, M.D., of Texas Children's Hospital, in Houston. About two-thirds of infants under 6 months with pertussis end up in the hospital. "They're more likely to suffer from complications such as pneumonia and brain damage," Dr. Healy says. The long coughing spells can starve the brain of oxygen.

Until their third diphtheria-tetanus-acellular pertussis (DTaP) shot at 6 months, infants are highly susceptible to pertussis, so the best way to keep young babies from getting it is to make sure all family members and caregivers have gotten their boosters and other vaccinations -- a strategy called cocooning.

Cocooning also makes sense when it comes to the flu, another disease that can make babies very sick but which they can't be vaccinated against until 6 months. Influenza is also highly dangerous to pregnant women in the second and third trimesters, which is why the shot is recommended to them when flu season rolls around.

Back in North Carolina, a fully recovered and fully immunized Briar Tomcho has just turned 3. When his baby sister, Tade, was born last summer, Tomcho made sure everyone around her was vaccinated. "Grandparents, friends, aunts, and uncles," she says, "unless they'd had the adult vaccine for pertussis, they did not come into our house! All the children had to be up-to-date as well."

Where to get more info

• cispimmunize.org The American Academy of Pediatrics's website provides complete information on vaccines, including answers to safety questions, up-to-date schedules, and vaccine-supply updates.

• vaccinateyourbaby.org The website of Every Child By Two, which works to educate and inform parents about vaccines and their history. There's also a cool timeline on the history of vaccinations.

• cdc.gov/vaccines The Centers for Disease Control and Prevention's comprehensive site, with all the latest news, downloadable publications, brochures, and statistics.

Jessica Snyder Sachs is the author of Good Germs, Bad Germs, out in paperback this fall.

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