38-Day-Old Baby Dies After Persisting Cough

April 28, 2010 -- Baby Callie was a miracle baby to Katie and Craig VanTourhout of South Bend, Ind. After four miscarriages, Katie VanTourhout got pregnant again in 2009 and this time it was a success.

It was an easy, healthy pregnancy, VanTourhout said her doctors told her. Her doctor made sure she had flu shots, she said. And then, six weeks before she was due, Callie Grace was born on Christmas Day.

"Once they said we were in the clear, we jumped for joy and we were just giddy all the time," VanTourhout said.

But when Callie was a couple weeks old, she developed a cough, so the VanTourhouts checked in with their pediatrician.

Although Katie VanTourhout said doctors told them it was nothing too serious, the cough persisted, and during a return visit to the doctor, Callie stopped breathing and was rushed to the hospital.

Two days later, at 38 days old, Callie stopped breathing again and could not be saved.

Callie somehow caught a highly contagious bacterial disease called pertussis, better known as whooping cough. While many believe that the disease is relatively rare in the United States, especially after the introduction of the vaccine in the 1940s, cases of whooping cough rose steadily from the 1980s to 2005, especially among teens and babies less than 6 months old, according to the Centers for Disease Control and Prevention.

In 2008 there were more than 13,000 cases of whooping cough, 18 of which were fatal, in the United States, according to the CDC. The most common complication associated with whooping cough is bacterial pneumonia.

"If we looked carefully enough we'd find pertussis in all age groups, but it's more serious in infants with smaller passageways," said Dr. Yvonne Maldonado, chief of pediatric infectious disease at Lucile Packard Children's Hospital in Palo Alto, Calif.

However, a schedule of vaccines could significantly reduce the amount of cases, she said. The CDC recommends five doses of DTaP, or tetanus, diphtheria, and pertussis vaccine by age seven.

But while Callie was too young to receive the vaccine, family members and those around Callie should have been immunized. Transmission by adults who are not vaccinated themselves or who have not recieved the recommended booster shot is responsible for most pertussis cases among babies. In fact, half of babies with pertussis are infected by their parents.

While it is uncertain whether whooping cough was transmitted from Katie VanTourhout to Callie, Katie VanTourhout said she never received Tdap -- the adult recommended booster shot -- before her pregnancy and was not offered the vaccine postpartum.

"We had no idea what the whooping cough vaccination was, that they wanted mothers to have," VanTourhout said. "Nobody mentioned it to us, nobody brought it up to us, nobody talked about it. We honestly had no clue."

While most adults and teens were vaccinated against pertussis as children, immunity against the disease decreases over time. The CDC recommends that adolescents and all adults aged 19 to 64, particularly those who have close contact with a young baby, should be immunized with a single Tdap booster vaccine against tetanus, diphtheria and pertussis.

"Pregnant women can get vaccinated," Maldonado said. "And if a mother doesn't get it before she gets pregnant, then she should get it postpartum."

Recognizing the Signs

While vaccines may ward against the disease, according to experts, it's hard for many parents to distinguish the symptoms of whooping cough and other illnesses.

"[Whooping cough] is one of the only vaccine-preventable diseases that is on the rise. People are walking around coughing and coughing but they don't know the difference between a cough and whooping cough," said Amy Pisani, executive director of the non-profit organization, Every Child by Two.

Indeed, whooping cough may start out looking like the common cold, said ABC News senior health and medical editor Dr. Richard Besser. However, more severe coughing bouts start about 10 to 12 days later. And, in children, the coughing often ends with a "whoop" noise, said Besser.

"The sound is produced when the patient tries to take a breath," he said. "The whoop noise is rare in patients under 6 months of age and in adults, so you have to look for other symptoms in infants. For example, they may cough until they vomit, choke or lose consciousness."

Most unvaccinated children living with someone who has pertussis will get the disease, and 90 percent of pertussis-associated deaths have been among babies less than a year old, according to a 2003 study published in the Pediatric Infectious Disease Journal.

Treating whooping cough is difficult because even though it is considered a bacterial infection, the inflammation persists longer than the infection, Maldonado said. Antibiotics are effective if whooping cough is detected early, she said. However, oftentimes many weeks may pass before the symptoms distinguish the child's whooping cough from a cold.

"That makes it days and weeks that the child has whooping cough and it is too late for antibiotics," Maldonado said.

The VanTornhouts are speaking out and urging mothers to vaccinate themselves and their children against a seemingly forgotten, deadly disease.

"We want to help somebody else, before someone else's baby goes through this and parents don't suffer the loss of their miracle baby," VanTornhout said. "We believe that every new mom should be required to get this new vaccination. I'm going to do it in Callie's name."

For more information on pertussis, go to: www.vaccinateyourbaby.org or http://soundsofpertussis.com