| Immunization vaccines, immunization worries. Bright Tots - Information on child development - Autism information. |
| Autism and Immunization Worries |
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Parents may be concern about immunizations causing autism in children. Although there are many benefits from immunization, some parents question the need for or safety of childhood vaccines. These parents may choose to delay or refrain from immunizing their children from some or all of the recommended vaccines. Before making immunization decisions parents should be fully informed, and try to be aware of differing views of vaccine risks and benefits and choose effectively.
Immunization of children has been called one of the most important public health interventions in history, after safe drinking water. It has saved millions of lives over the years and prevented hundreds of millions of cases of disease. We all know that getting our children immunized can protect them from some very serious diseases. Some children can’t get certain vaccines for medical reasons, other children don’t respond well to certain vaccines. For these children, the immunity of people around them is their only protection.
Immunizations help the child’s immune system function. The child develops protection against future infections, the same as if he or she had been exposed to the natural disease. Except with vaccines children don’t have to get sick first to get that protection. The purpose of immunizations is to prevent disease.
Today, children in the United States routinely get immunizations that protect them from diseases. Some childhood vaccines have been used since the 1940s, others have been around for only a short time. Currently there are 10 routinely used vaccines that protect children against the 14 diseases. These diseases have, at one time or another, been a serious threat to children in this country. Most of them are now at their lowest levels in history, thanks to years of immunization.
Immunizations Used on Children
Diphtheria
Diphtheria caused by a bacterium called Corynebacterium diphtheriae. It lives in the mouth, throat and nose of an infected person and can be spread to others by coughing or sneezing. A child with diphtheria can infect others for 2 to 4 weeks.
Diphtheria can initially cause a sore throat, fever and chills. But if it is not properly diagnosed and treated it produces a toxin (poison) that can cause serious complications such as heart failure or paralysis. About 1 person out of 10 who get diphtheria dies from it. Diphtheria used to be a major cause of childhood illness and death. Through the 1920s about 150,000 people a year got diphtheria in the United States, and about 15,000 of them died.
DTaP Vaccine
DTaP combines vaccines against three diseases, Diphtheria, Tetanus and Pertussis (Whooping Cough) into one shot. (The small “a” in the name stands for “acellular,” which means that the pertussis component of the vaccine contains only parts of the pertussis bacterium rather than the whole cell.) The diphtheria and tetanus components of the vaccine are not technically vaccines, but a substance that is normally toxic but has been treated to destroy its toxic properties. They help the immune system develop protection against the poisons produced by the diseases rather than against the disease bacteria themselves. All three components of DTaP are “inactivated” (killed). Tetanus, diphtheria and pertussis (DTP) vaccines have been in common use since the 1940s. DTaP vaccine (with the acellular pertussis component) was first licensed in 1991.
Children need five DTaP shots for maximum protection. The first three shots are given at 2, 4, and 6 months of age. The fourth (booster) shot is given between 15 and 18 months, and a fifth shot, another booster, is given when a child enters school, at 4–6 years. When it is given according to this schedule, DTaP protects most children from all three diseases (80%–85% from pertussis, 95% from diphtheria, nearly 100% from tetanus). Protection can fade with time, so booster doses (using Td or Tdap vaccine, see below) are recommended every 10 years. These vaccines are also sometimes given when a person gets a serious wound that could contain tetanus bacteria.
Hepatitis A
Hepatitis A is a liver disease caused by the hepatitis A virus. Until 2004 it was the most frequently reported type of hepatitis in the United States. Disease rates have been dropping since 1995, when a vaccine was licensed. There are now estimated to be about 20,000 cases a year in the United States. The virus is found mainly in bowel movements and is spread through personal contact or by eating contaminated food or drinking contaminated water. Children under 6 often don’t show any signs of illness, but for older children signs include fever, loss of appetite, tiredness, stomach pain, vomiting, dark urine, and yellow skin or eyes (jaundice). Hepatitis A does not cause long-term illness or permanent liver damage, but about 100 people die each year from liver failure caused by severe hepatitis A.
Hepatitis A Vaccine
Hepatitis A vaccine is made from inactivated (killed) hepatitis A virus. It is 94%–100% effective in preventing hepatitis A. Because it has been available only since 1995, it’s yet unknown how long immunity will last, but mathematical research suggests that it should protect for 20 years or more. The vaccine is not licensed for children younger than 1 year of age.
Until late 2005 hepatitis A vaccine was recommended only for certain children: those who live in states where risk of hepatitis A is highest and those who live in communities with high levels of hepatitis A, including Alaska Native villages, American Indian reservations, some Hispanic communities, and some religious communities. Travelers to countries where the disease is common should also get the vaccine.
As of 2005 hepatitis A vaccine has been routinely recommended for all children from 12 through 23 months of age. Two doses of hepatitis A vaccine are recommended, the second dose given at least 6 months after the first.
Hepatitis B
Hepatitis B is also a liver disease (the word “hepatitis” comes from the Greek words for “liver” and “inflammation”). It is caused by the hepatitis B virus. It is spread through contact with the blood, or other body fluids, of an infected person. Adolescents and adults can be infected through sharing drug needles or through unprotected sex, and health-care and public safety workers are often exposed to blood in the course of their jobs. People infected with hepatitis B might not feel sick, or might suffer loss of appetite or tiredness, muscle or stomach pains, diarrhea or vomiting, or yellow skin or eyes (jaundice). People usually recover from hepatitis B after several weeks, but others become “chronically infected.” They might not feel sick themselves, but they continue to carry the virus and can infect other people.
Pregnant women can infect their newborn babies. A baby who is born to a chronically infected mother has a 70%–90% chance of being infected at birth. Many people who are chronically infected will suffer from serious problems such as cirrhosis (scarring of the liver) or liver cancer. More than a million people in the United States are chronically infected with hepatitis B. In 1996 an estimated 200,000 people became infected, and 4,000 to 5,000 people die each year from hepatitis B.
Hepatitis B Vaccine
Hepatitis B vaccine is an inactivated (killed) vaccine that is made from a small, non-infectious part of the hepatitis B virus, called hepatitis B surface antigen (any substance that can stimulate the production of antibodies and combine specifically with them). The vaccine was licensed in 1986, and 98%–100% of children who get the vaccine develop immunity.
Some parents question why infants and young children should be vaccinated against hepatitis B when they don’t have the risk factors (drug use, sexual activity, professional risk) that lead to many infections. There are two reasons. One is that babies and children can become infected too. If a mother infects her baby during birth, for example, and the baby is not immunized immediately, it will probably become chronically infected too. One out of 4 of these children will eventually die from cirrhosis (a disease of the liver) or liver cancer. The other reason is that vaccinating only high-risk adolescents and adults has proved not to be a very effective way to control the disease. It was only after they began routine childhood vaccination that rates of disease began to drop significantly.
Three doses of hepatitis B vaccine are needed for full protection. The first dose is recommended at birth. This is particularly important for children whose mothers are chronically infected. The second dose is recommended at 1–4 months and the third at 6–18 months. These three doses should protect children for life. No additional booster doses are needed.
Hib disease (Haemophilus influenzae type b)
Not long ago Hib disease (Haemophilus influenzae type b) was the leading cause of bacterial meningitis in children less than 5 years old. As recently as the mid-1980s it struck one child out of every 200 in that age group. About 1 in 4 of these children suffered permanent brain damage, and about 1 in 20 died. Hib disease is spread through the air by coughing, sneezing, and even breathing. If the bacteria stay in a child’s nose and throat, the child will probably not get sick. But if they spread to the lungs or bloodstream, the child can get meningitis (inflammation of the covering of the brain), pneumonia, epiglottitis (inflammation in the throat), arthritis, or other problems. A child who is infected can spread the disease to others for as long as the bacteria remain in the body. Antibiotics can stop spread in 2 to 4 days.
Influenza (Flu)
Influenza (Flu) is a seasonal illness, occurring mainly during the winter. It is caused by influenza virus. Influenza viruses are continually changing, meaning that immunity (the condition that permits either natural or acquired resistance to disease) you gain one year will not necessarily protect you in future years. This makes influenza different from most diseases, in that you can get it more than once. It also means that it is important to be vaccinated every year.
Influenza is spread from person to person through sneezing, coughing or breathing. Signs and symptoms include fever, sore throat, cough, headache, chills and muscle aches. Young children might also have vomiting and diarrhea. Complications can include ear and sinus infections, pneumonia, myocarditis (inflammation of the heart), and death. Influenza causes more deaths (about 36,000 per year) than any other vaccine-preventable disease. Most of these are among the elderly, but some children also die. Hospitalization rates are high among children, particularly those less than 1 year old.
Influenza Vaccine
There are two types of influenza vaccine. The first is an inactivated (killed) vaccine given as a shot, which has been used for many years. It can be given to anyone 6 months of age and older. The second is a live, weakened vaccine, which is sprayed into the nose and was licensed in 2003. It is not licensed for children younger than 2 years old.
Because influenza viruses change from year to year, new vaccines must also be formulated each year, and annual vaccination is recommended. The inactivated influenza vaccine is 70%–90% effective in healthy children, and the live, intranasal vaccine is about 87% effective in healthy children 5–7 years of age.
Many other infections have the same symptoms as influenza and are often mistakenly called “flu.” Neither vaccine is effective against infections that are not actually caused by influenza viruses.
One dose of vaccine (either type, depending on age) is recommended annually, beginning around October or November. For children younger than 9 who are getting influenza vaccine for the first time, 2 doses are recommended, and should be given at least a month apart.
Measles
Measles is a viral illness that causes a rash all over the body. It also causes fever, runny nose and cough. About 1 out of 10 children with measles also get an ear infection, and up to 1 out of 20 get pneumonia. About 1 out of 1,000 get encephalitis (inflammation of the substance of the brain) and 1 or 2 out of 1,000 die. While measles is almost gone from the United States, it still kills about half a million people a year around the world. Measles can also make a pregnant woman have a miscarriage or give birth prematurely.
Measles spreads through the air by breathing, coughing or sneezing. It is so contagious that any child who is exposed to it and is not immune will probably get the disease. Before measles vaccine, nearly all children got measles by the time they were 15. Each year about 450 people died because of measles, 48,000 were hospitalized, 7,000 had seizures, and about 1,000 suffered permanent brain damage or deafness. Today there are only about 50 cases a year reported in the United States, and most of these originate outside the country.
Mumps
Mumps is best known for the swelling of the cheeks and jaw that it causes a result of inflammation of the salivary glands. Mumps also causes a fever and headache. It is usually a mild disease, but it leads to meningitis in about 1 child in 10 who get the disease. It can occasionally cause encephalitis, deafness (about 1 in 20,000 cases), or even death (about 1 in 10,000 cases).
Mumps is caused by the mumps virus, which is spread from person to person through the air. Before a vaccine was available mumps was a very common childhood illness. About 152,000 cases were reported each year. Now mumps is very uncommon, with only 314 cases reported in 2005.
MMR - Measles, Mumps, and Rubella Vaccine
MMR combines vaccines for Measles, Mumps and Rubella into one shot. MMR has been around since 1971, although its three components were licensed separately during the 1960s. It is a live vaccine, containing measles, mumps and rubella viruses that have been weakened, so they won’t cause disease. Most children who get the vaccine develop immunity to all three diseases (over 99% for measles and 95% for mumps and rubella). Protection is believed to be life-long.
Two doses of vaccine are recommended, with the first dose given at 12–15 months of age. The second dose may be given 4 weeks after the first, but it is usually given at 4–6 years. Measles, mumps and rubella vaccines may be given separately, although these individual vaccines are not always readily available. Doctors usually prefer not to give the vaccines this way because it means giving a child 3 shots instead of one.
Pertussis (Whooping Cough)
Pertussis (Whooping Cough) is caused by a bacterium called Bordetella pertussis. If you have ever seen a child with Whooping Cough you won’t forget it. The child coughs violently and rapidly, over and over, until the air is gone from her lungs and she is forced to inhale with the loud “whooping” sound that gives the disease its nickname, whooping cough.
Pertussis is a very contagious disease, and one that is fairly common in the United States, even today. In 2005, over 25,000 cases were reported. While this is down considerably from the approximately 150,000 cases a year before the vaccine, it still makes it one of the most common vaccine preventable childhood diseases in the country. It is spread from person to person through personal contact, coughing and sneezing.
At first Whooping Cough is similar to a common cold, with sneezing, runny nose, fever and a mild cough. But after 1 or 2 weeks the severe coughing spells begin. Pertussis is most severe in infants less than 1 year old. More than half of these infants who get the disease must be hospitalized. Older children and adults can get pertussis too, but it is usually not as serious. Many infants who get Whooping Cough catch it from their older brothers and sisters, or from their parents, who might not be aware they have the disease. About 1 child in 10 who get pertussis also gets pneumonia, and about 1 in 50 will have seizures. The brain is affected in about 1 person out of 250 (this is called encephalopathy, any of various diseases of the brain). Pertussis causes about 10–20 deaths each year in the United States.
Immunization of children has been called one of the most important public health interventions in history, after safe drinking water. It has saved millions of lives over the years and prevented hundreds of millions of cases of disease. We all know that getting our children immunized can protect them from some very serious diseases. Some children can’t get certain vaccines for medical reasons, other children don’t respond well to certain vaccines. For these children, the immunity of people around them is their only protection.
Immunizations help the child’s immune system function. The child develops protection against future infections, the same as if he or she had been exposed to the natural disease. Except with vaccines children don’t have to get sick first to get that protection. The purpose of immunizations is to prevent disease.
Today, children in the United States routinely get immunizations that protect them from diseases. Some childhood vaccines have been used since the 1940s, others have been around for only a short time. Currently there are 10 routinely used vaccines that protect children against the 14 diseases. These diseases have, at one time or another, been a serious threat to children in this country. Most of them are now at their lowest levels in history, thanks to years of immunization.
Immunizations Used on Children
Diphtheria
Diphtheria caused by a bacterium called Corynebacterium diphtheriae. It lives in the mouth, throat and nose of an infected person and can be spread to others by coughing or sneezing. A child with diphtheria can infect others for 2 to 4 weeks.
Diphtheria can initially cause a sore throat, fever and chills. But if it is not properly diagnosed and treated it produces a toxin (poison) that can cause serious complications such as heart failure or paralysis. About 1 person out of 10 who get diphtheria dies from it. Diphtheria used to be a major cause of childhood illness and death. Through the 1920s about 150,000 people a year got diphtheria in the United States, and about 15,000 of them died.
DTaP Vaccine
DTaP combines vaccines against three diseases, Diphtheria, Tetanus and Pertussis (Whooping Cough) into one shot. (The small “a” in the name stands for “acellular,” which means that the pertussis component of the vaccine contains only parts of the pertussis bacterium rather than the whole cell.) The diphtheria and tetanus components of the vaccine are not technically vaccines, but a substance that is normally toxic but has been treated to destroy its toxic properties. They help the immune system develop protection against the poisons produced by the diseases rather than against the disease bacteria themselves. All three components of DTaP are “inactivated” (killed). Tetanus, diphtheria and pertussis (DTP) vaccines have been in common use since the 1940s. DTaP vaccine (with the acellular pertussis component) was first licensed in 1991.
Children need five DTaP shots for maximum protection. The first three shots are given at 2, 4, and 6 months of age. The fourth (booster) shot is given between 15 and 18 months, and a fifth shot, another booster, is given when a child enters school, at 4–6 years. When it is given according to this schedule, DTaP protects most children from all three diseases (80%–85% from pertussis, 95% from diphtheria, nearly 100% from tetanus). Protection can fade with time, so booster doses (using Td or Tdap vaccine, see below) are recommended every 10 years. These vaccines are also sometimes given when a person gets a serious wound that could contain tetanus bacteria.
Hepatitis A
Hepatitis A is a liver disease caused by the hepatitis A virus. Until 2004 it was the most frequently reported type of hepatitis in the United States. Disease rates have been dropping since 1995, when a vaccine was licensed. There are now estimated to be about 20,000 cases a year in the United States. The virus is found mainly in bowel movements and is spread through personal contact or by eating contaminated food or drinking contaminated water. Children under 6 often don’t show any signs of illness, but for older children signs include fever, loss of appetite, tiredness, stomach pain, vomiting, dark urine, and yellow skin or eyes (jaundice). Hepatitis A does not cause long-term illness or permanent liver damage, but about 100 people die each year from liver failure caused by severe hepatitis A.
Hepatitis A Vaccine
Hepatitis A vaccine is made from inactivated (killed) hepatitis A virus. It is 94%–100% effective in preventing hepatitis A. Because it has been available only since 1995, it’s yet unknown how long immunity will last, but mathematical research suggests that it should protect for 20 years or more. The vaccine is not licensed for children younger than 1 year of age.
Until late 2005 hepatitis A vaccine was recommended only for certain children: those who live in states where risk of hepatitis A is highest and those who live in communities with high levels of hepatitis A, including Alaska Native villages, American Indian reservations, some Hispanic communities, and some religious communities. Travelers to countries where the disease is common should also get the vaccine.
As of 2005 hepatitis A vaccine has been routinely recommended for all children from 12 through 23 months of age. Two doses of hepatitis A vaccine are recommended, the second dose given at least 6 months after the first.
Hepatitis B
Hepatitis B is also a liver disease (the word “hepatitis” comes from the Greek words for “liver” and “inflammation”). It is caused by the hepatitis B virus. It is spread through contact with the blood, or other body fluids, of an infected person. Adolescents and adults can be infected through sharing drug needles or through unprotected sex, and health-care and public safety workers are often exposed to blood in the course of their jobs. People infected with hepatitis B might not feel sick, or might suffer loss of appetite or tiredness, muscle or stomach pains, diarrhea or vomiting, or yellow skin or eyes (jaundice). People usually recover from hepatitis B after several weeks, but others become “chronically infected.” They might not feel sick themselves, but they continue to carry the virus and can infect other people.
Pregnant women can infect their newborn babies. A baby who is born to a chronically infected mother has a 70%–90% chance of being infected at birth. Many people who are chronically infected will suffer from serious problems such as cirrhosis (scarring of the liver) or liver cancer. More than a million people in the United States are chronically infected with hepatitis B. In 1996 an estimated 200,000 people became infected, and 4,000 to 5,000 people die each year from hepatitis B.
Hepatitis B Vaccine
Hepatitis B vaccine is an inactivated (killed) vaccine that is made from a small, non-infectious part of the hepatitis B virus, called hepatitis B surface antigen (any substance that can stimulate the production of antibodies and combine specifically with them). The vaccine was licensed in 1986, and 98%–100% of children who get the vaccine develop immunity.
Some parents question why infants and young children should be vaccinated against hepatitis B when they don’t have the risk factors (drug use, sexual activity, professional risk) that lead to many infections. There are two reasons. One is that babies and children can become infected too. If a mother infects her baby during birth, for example, and the baby is not immunized immediately, it will probably become chronically infected too. One out of 4 of these children will eventually die from cirrhosis (a disease of the liver) or liver cancer. The other reason is that vaccinating only high-risk adolescents and adults has proved not to be a very effective way to control the disease. It was only after they began routine childhood vaccination that rates of disease began to drop significantly.
Three doses of hepatitis B vaccine are needed for full protection. The first dose is recommended at birth. This is particularly important for children whose mothers are chronically infected. The second dose is recommended at 1–4 months and the third at 6–18 months. These three doses should protect children for life. No additional booster doses are needed.
Hib disease (Haemophilus influenzae type b)
Not long ago Hib disease (Haemophilus influenzae type b) was the leading cause of bacterial meningitis in children less than 5 years old. As recently as the mid-1980s it struck one child out of every 200 in that age group. About 1 in 4 of these children suffered permanent brain damage, and about 1 in 20 died. Hib disease is spread through the air by coughing, sneezing, and even breathing. If the bacteria stay in a child’s nose and throat, the child will probably not get sick. But if they spread to the lungs or bloodstream, the child can get meningitis (inflammation of the covering of the brain), pneumonia, epiglottitis (inflammation in the throat), arthritis, or other problems. A child who is infected can spread the disease to others for as long as the bacteria remain in the body. Antibiotics can stop spread in 2 to 4 days.
Influenza (Flu)
Influenza (Flu) is a seasonal illness, occurring mainly during the winter. It is caused by influenza virus. Influenza viruses are continually changing, meaning that immunity (the condition that permits either natural or acquired resistance to disease) you gain one year will not necessarily protect you in future years. This makes influenza different from most diseases, in that you can get it more than once. It also means that it is important to be vaccinated every year.
Influenza is spread from person to person through sneezing, coughing or breathing. Signs and symptoms include fever, sore throat, cough, headache, chills and muscle aches. Young children might also have vomiting and diarrhea. Complications can include ear and sinus infections, pneumonia, myocarditis (inflammation of the heart), and death. Influenza causes more deaths (about 36,000 per year) than any other vaccine-preventable disease. Most of these are among the elderly, but some children also die. Hospitalization rates are high among children, particularly those less than 1 year old.
Influenza Vaccine
There are two types of influenza vaccine. The first is an inactivated (killed) vaccine given as a shot, which has been used for many years. It can be given to anyone 6 months of age and older. The second is a live, weakened vaccine, which is sprayed into the nose and was licensed in 2003. It is not licensed for children younger than 2 years old.
Because influenza viruses change from year to year, new vaccines must also be formulated each year, and annual vaccination is recommended. The inactivated influenza vaccine is 70%–90% effective in healthy children, and the live, intranasal vaccine is about 87% effective in healthy children 5–7 years of age.
Many other infections have the same symptoms as influenza and are often mistakenly called “flu.” Neither vaccine is effective against infections that are not actually caused by influenza viruses.
One dose of vaccine (either type, depending on age) is recommended annually, beginning around October or November. For children younger than 9 who are getting influenza vaccine for the first time, 2 doses are recommended, and should be given at least a month apart.
Measles
Measles is a viral illness that causes a rash all over the body. It also causes fever, runny nose and cough. About 1 out of 10 children with measles also get an ear infection, and up to 1 out of 20 get pneumonia. About 1 out of 1,000 get encephalitis (inflammation of the substance of the brain) and 1 or 2 out of 1,000 die. While measles is almost gone from the United States, it still kills about half a million people a year around the world. Measles can also make a pregnant woman have a miscarriage or give birth prematurely.
Measles spreads through the air by breathing, coughing or sneezing. It is so contagious that any child who is exposed to it and is not immune will probably get the disease. Before measles vaccine, nearly all children got measles by the time they were 15. Each year about 450 people died because of measles, 48,000 were hospitalized, 7,000 had seizures, and about 1,000 suffered permanent brain damage or deafness. Today there are only about 50 cases a year reported in the United States, and most of these originate outside the country.
Mumps
Mumps is best known for the swelling of the cheeks and jaw that it causes a result of inflammation of the salivary glands. Mumps also causes a fever and headache. It is usually a mild disease, but it leads to meningitis in about 1 child in 10 who get the disease. It can occasionally cause encephalitis, deafness (about 1 in 20,000 cases), or even death (about 1 in 10,000 cases).
Mumps is caused by the mumps virus, which is spread from person to person through the air. Before a vaccine was available mumps was a very common childhood illness. About 152,000 cases were reported each year. Now mumps is very uncommon, with only 314 cases reported in 2005.
MMR - Measles, Mumps, and Rubella Vaccine
MMR combines vaccines for Measles, Mumps and Rubella into one shot. MMR has been around since 1971, although its three components were licensed separately during the 1960s. It is a live vaccine, containing measles, mumps and rubella viruses that have been weakened, so they won’t cause disease. Most children who get the vaccine develop immunity to all three diseases (over 99% for measles and 95% for mumps and rubella). Protection is believed to be life-long.
Two doses of vaccine are recommended, with the first dose given at 12–15 months of age. The second dose may be given 4 weeks after the first, but it is usually given at 4–6 years. Measles, mumps and rubella vaccines may be given separately, although these individual vaccines are not always readily available. Doctors usually prefer not to give the vaccines this way because it means giving a child 3 shots instead of one.
Pertussis (Whooping Cough)
Pertussis (Whooping Cough) is caused by a bacterium called Bordetella pertussis. If you have ever seen a child with Whooping Cough you won’t forget it. The child coughs violently and rapidly, over and over, until the air is gone from her lungs and she is forced to inhale with the loud “whooping” sound that gives the disease its nickname, whooping cough.
Pertussis is a very contagious disease, and one that is fairly common in the United States, even today. In 2005, over 25,000 cases were reported. While this is down considerably from the approximately 150,000 cases a year before the vaccine, it still makes it one of the most common vaccine preventable childhood diseases in the country. It is spread from person to person through personal contact, coughing and sneezing.
At first Whooping Cough is similar to a common cold, with sneezing, runny nose, fever and a mild cough. But after 1 or 2 weeks the severe coughing spells begin. Pertussis is most severe in infants less than 1 year old. More than half of these infants who get the disease must be hospitalized. Older children and adults can get pertussis too, but it is usually not as serious. Many infants who get Whooping Cough catch it from their older brothers and sisters, or from their parents, who might not be aware they have the disease. About 1 child in 10 who get pertussis also gets pneumonia, and about 1 in 50 will have seizures. The brain is affected in about 1 person out of 250 (this is called encephalopathy, any of various diseases of the brain). Pertussis causes about 10–20 deaths each year in the United States.
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