When Jill Evans’ gave birth to a baby girl in mid-January 2009, she was elated, yet concerned. Baby Grace had arrived a few weeks early and was on the small side, but she thrived until she was about four weeks old. “She suddenly seemed sort of lethargic, sleeping a lot,” says Jill, a mother and schoolteacher who lives in Winston, outside of Roseburg. “Then she started coughing, it almost sounded like she was choking.”
The pediatrician first thought acid reflux caused Grace’s coughing and vomiting. “They treated her with medication and ran imaging tests for something she didn’t even have,” Jill says. But the coughing continued to the point where Grace was so sick she wouldn’t even eat. Jill tried pumping breast milk and feeding it to Grace with a dropper, but the infant would just throw it up minutes later. Finally, Grace woke only to cough and choke. Jill and her husband Scott grew gravely concerned for their tiny baby. “We were scared,” says Jill. “I finally got a pediatrician on the phone who said ‘take her to the ER and have them test her for pertussis.’”
Pertussis, also known as whooping cough, is a highly contagious respiratory infection that causes a strangling cough, which can last for months. It is particularly dangerous for tiny newborns who are too young to be vaccinated and have a very tough time getting through the wracking cough.
Jill says it was very frustrating in the ER. They tested Grace for pertussis with a nasal swab, then drew blood for other tests. “By this point she was pretty limp and seemed almost lifeless,” says Jill, “so she wasn't fighting the blood draws, but it was a challenge to get it done in between her coughing/choking fits.” Then they tried to send the family home. “We didn’t feel safe having her at home,” Jill says. “She was struggling to breathe.” At 2 a.m., the nurses were trying to put oxygen over Grace’s face so she could get air. At 3 a.m., the pediatrician-on-call, who had a bad feeling, arrived at the hospital and noticed Grace’s heart rate was elevated to 215. They life-flighted the baby to Doernbecher Children’s Hospital and put her in the Intensive Care Unit (ICU).
Jill says it was horrible waiting for the antibiotics to work. “She had coughing spells all night long and they were advising us to hold her tiny body up with our hands under her armpits while lifting her arms high in the air allowing her body to hang down to try to relieve her chest when she had the spells,” Jill says. “The first couple of night and days seemed like that's all we were doing. She was put on oxygen and had a feeding tube along with multiple IVs for antibiotics and hydration.” After six days in ICU, Grace finally began to get better. Her brother Noah, two years older, received antibiotics as well. Today, they are both happy, healthy, fully immunized children.
Thinking back, Jill believes Grace caught whooping cough from her. “I didn’t realize the whooping cough vaccine wears off and adults need to get a booster,” she says. “I worked around sick kids right up to the time Grace was born,” she says, “and I had a bad cough myself when she was about two weeks old. Some people around us were getting tested for pertussis.” If she had known, Jill would have made sure both she and her husband were vaccinated against whooping cough when Grace was born.
The Advisory Committee for Immunization Practices (ACIP) now recommends Tdap for each and every pregnancy for mom, preferably between 27 and 36 weeks. The rest of the family (and anyone who will be in contact with the newborn) should be vaccinated before baby's arrival. The vaccine takes about two weeks to kick in.