When my daughter was nearly 6 weeks old, we flew to Sydney so she could meet grandparents, great grandparents, aunts and uncles and family friends. It was a lovely trip. Unfortunately, she was exposed to Pertussis (Whooping Cough), probably at the airport or on the flight on the way home. Two weeks later she developed a cough which steadily got worse over the next couple of weeks.*
A at about 6 weeks old
After several trips to the GP and many phone calls to Nurse-on-Call, we eventually ended up in the Children's Hospital in an isolation ward for a few nights so that her symptoms could be managed. The GP didn't pick it up because the symptoms look so different in an infant compared to an older child or adult. As infants don't have the muscle strength to do the characteristic cough, when it gets severe enough they stop breathing instead. As a parent, it's incredibly distressing to witness, and requires being on high alert ALL the time so that you can sit the baby up during a coughing fit to try to keep their airways clear. The only treatment available for Pertussis is a course of antibiotics, which limits the contagious period to 5 days from the beginning of the course of antibiotics (as opposed to 3 weeks if left untreated). It does nothing to treat the symptoms, which need to be constantly monitored and managed.
In the last couple of weeks, a five week old baby in South Australia died as a result of Pertussis. This was apparently the fourth infant in Australia to die in the last 12 months, when typically in this country, there is only one Pertussis related death each year. The disease is not life threatening for most people over the age of 12 months (though when my sister had it a few years ago, she broke a rib with all the coughing), but in small babies they don't have the strength to cough as effectively, which means their airways can be compromised, and they can end up too exhausted to feed which further reduces their strength, which can spiral down into a very bad place to be. Fortunately, if you make it past the worst of it about 2 weeks after the cough first appears, there are no lasting side effects once the 3 month (very) gradual recovery is complete.
We were lucky. My daughter's case was considered 'moderate', which meant she didn't get to the point of needing to be tube-fed and only had oxygen waved over her face during a coughing fit rather than it being attached permanently. Thankfully she was a great feeder from birth, and consequently a fatty-boom-sticks which I suspect put her in a more resilient position to start with than many babies often are. She is now completely healthy, and amazingly, given the levels of adult anxiety she was exposed to while she was sick, is a joyful, carefree, adventurous little thing. It doesn't seem to have had any long term impact.
But now we're about to have another baby. And the rate of Pertussis in the community is again significantly higher than normal. And I'm feeling slightly paranoid. I REALLY don't want this child to get it. I'm not sure I could be as together if it happened again - I know a lot more about it and the potential consequences now than I did last time! Sometimes lack of knowledge is a good thing... We WILL vaccinate this child**, but it will still be completely unprotected for the first 8 weeks of life.
The conversation with my rational brain goes something like this:
My SIL had a baby 2 months ago and when they left the hospital they were advised that, in addition to ensuring that any adults who were likely to have regular contact with her (like parents and grandparents***) were up to date with their vaccinations, to keep her away from public places, especially those with air conditioning (like shopping centres). My advice at the time was to be cautious and sensible but that they couldn't let the unlikely possibility shut them in the house for the first 8 weeks! Obviously that applies to us, too!
Here is a sample of the conversation with my slightly less rational brain:
Our daughter caught it in one of those public place scenarios!! We can't go anywhere public then!! Well at least not to the shops. Or church. Or cafes. And only people who are up to date with their vaccinations can come into our house!! And so on...
There's got to be some kind of middle ground here! Listening too closely to my irrational brain is a recipe for serious mental health issues. However, it's not completely crazy. I suspect that not being cautious enough and getting into the same situation again would result in psychological catastrophe too. Obviously, we won't be going anywhere near airports or public transport for the first few weeks of life (been there, done that, outcome not good). The question is: Where do we draw the line? When does caution become paranoia? What do you think?
*She was vaccinated, but babies don't receive their first lot until they're 8 weeks old, by which stage she'd already picked it up.
**I know there are many people who don't agree with vaccination, but it's something that we're committed to, especially in this situation.
***Babies typically pick it up from parents or grandparents who have not been vaccinated in the last 5 years. Most adults don't realise the vaccinations they received as children or teenagers have well and truly lost their effectiveness! And most adults who have Pertussis often don't get diagnosed until after they're no longer contagious, because it's the fact that it lingers for such a long time that often results in a diagnosis being made.