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Little Wings

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Carter Dube's death sheds light on pertussis

By Greg Summers

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Zachary Justice is flying to New York City today.

On Thursday morning, the 10-year-old will soak in the sights and sounds of Times Square, with his parents, Felicia and Daryl Dube.

But this isn’t some pie-in-the-sky, last-minute vacation for the fifth-grader, who returns to Buford Elementary School on Aug. 16.

This Big Apple adventure has nothing to do with Zach or his parents.

If they had their way, they’d be right here in Lancaster.

This visit has everything to do with the Dubes’ youngest son, Carter.

Carter, who died from pertussis (whooping cough) on Jan. 28, already has his wings. He was only 7 weeks old.

“Our lives changed forever,” Felicia said. “We lost first words, first steps, first birthdays and watching him grow into a sweet little boy. Daryl lost his first and only biological son; Zach lost his little brother and I lost my faith in what is fair in life.

“I have a strong faith, but watching Carter die so quickly and helplessly, it makes you question where God was that day,” Felicia said. “Was he too busy to help my baby or what?

Seven months later, I see a greater plan, but the hurt is still the same. It never changes.”

That divine plan is why the Dubes and Zach are in New York City this week.  

They are speaking up and speaking out to make sure no other parents have to go through what they’ve been through this year.

The couple is taking part in Thursday’s national Sound of Pertussis campaign. The initiative encourages parents to help protect themselves and the babies in their lives by getting an adult pertussis vaccine to reduce their risk of getting the disease and spreading it.

“I don’t want anyone else to have to suffer like that,” Felicia said. “It was the worst nightmare ever.”

A fiery little redhead, Carter arrived just after 5 p.m. Dec. 8, a little before Felicia’s planned Dec. 21 C-section.

Still, Carter was perfectly healthy – 6 pounds, 6 ounces and 18.5 inches long.

However, by Jan. 19, Carter had developed a slight fever. Felicia, 35, said at first, pediatricians thought it might be a cold or swine flu.

Then one of them mentioned pertussis (whooping cough). Felicia said she wrongfully thought pertussis was a disease of the past.

After Carter started coughing hard and turned blue, the tiny infant was taken to Levine Children’s Hospital in Charlotte, placed on a respirator and hooked to multiple tubes.

She said Carter fought a good fight, but died at 5:06 p.m. Jan. 28.

A mother never forgets those kind of mind-numbing details.

Their beautiful boy, who was the spitting image of his dad, was gone.

The Dubes have coped with the loss in different ways.

For Felicia, it’s been through tears.

“The closer it gets to 5:06 on the 28th, the heavier my heart gets,” she said. “By the time I get to my car, I’m in tears.

“I talk to Carter every day on my way home. I ask God to squeeze him a little tighter for me and to give him more kisses,” Felicia said. “I would always tell Carter when I was holding him that I was going to steal all of his kisses so he couldn’t share them with anyone else.” 

For Zach, it’s been grief counseling and sleeping with one of Carter’s blankets. He constantly tells his parents that he sees Carter in his dreams.

Daryl’s coping mechanism was found in remodeling the Dubes' home.

He says little, but the new hardwood floors, just-removed fireplace, freshly painted home interior and other improvements speak volumes.

The one thing left in the upgraded living room is the blue recliner Daryl sat in to rock Carter before he was hospitalized.

Carter was the first grandchild in Daryl’s family.

A certified EMT in North Carolina, Daryl, 33, and Felicia had decided that he would be a stay-at-home dad. Now he’s getting certified in South Carolina and plans to return to work.

“That was the plan,” Daryl said of his “Mr. Mom” role. “But now, all of that has changed. I have my times, too, but you just move on. That’s all you can do.”

What is pertussis?

Pertussis is a highly contagious infection caused by the Bordetella pertussis bacteria. It can be spread through airborne droplets expelled from the nose and throat through coughing, sneezing and even talking very close.

It’s named whooping cough for the “whooping” sound a person with the disease makes while trying to catch their breath between coughing fits.

In adults, the symptoms are usually mild and can be mistaken for a common cold or bronchitis.

Some people with pertussis might not feel very sick or develop coughing spells or the telltale “whoop,” but can still pass the infection on to others, said Adam Myrick, spokesman for the S.C. Department of Health and Environmental Control.

Myrick said many adults who received vaccinations when they were children believe they are still protected against pertussis, but the immunity wears off over time (between 5 five and 10 years) leaving them vulnerable to the disease.

“After time, the vaccine wanes,” Myrick said. 

However, pertussis can be so severe at times that it ruptures blood vessels in the face, eye and brain.

Pertussis can be horrible at any age, but it is most severe in infants under 12 months old because their airways are so small. Pertussis creates a sticky, thick mucus that makes it difficult to eat, drink and breathe.

Babies can cough until they turn blue because air is leaving their lungs and nothing is coming in. 

“It’s the most heart-wrenching thing you will ever see,” said Gil Potter, medical director for DHEC Region 3 (Lancaster, York, Chester, Fairfield, Newberry, Richland and Lexington counties).

“What an infant with pertussis goes through is just devastating,” he said.

By the numbers

Pertussis is an old-fashioned-sounding disease that has flared up with a vengeance.

Through June 5, there have been 4,198 cases of pertussis reported to the U.S. Centers for Disease Control (CDC) this year.

In California, whooping cough has become an whopping epidemic, with 1,500 cases this year and seven infant deaths reported through July 31, which is five times higher than last year.

The news isn’t much better for South Carolina.

In June, DHEC issued a health advisory that pertussis cases in the first 20 weeks of this year have doubled, compared to the same time periods in 2009, 2008 and 2007.  

According to the CDC, pertussis cases in the Palmetto State have exceeded an “epidemic threshold,” a statistical measure that means there are significantly more cases than usual for this time of the year. The number of cases usually peaks in late summer and early fall.

Myrick said as of June 30, DHEC’s Bureau of Disease Control had received 168 reports of pertussis, including two cases in Lancaster County.

There have been two deaths from pertussis in South Carolina this year, including Carter. Myrick said no pertussis deaths were reported in the state from 2006 to 2008.

Myrick said whooping cough outbreaks tend to run in three- to five-year cycles. During the same time periods in 2009, 2008, 2007 and 2006, there were 114, 62, 42 and 78 reports of pertussis, respectively.

“More physicians are reporting it, which means the system is working better,” Myrick said. “We take each case seriously and are seeing more of an upward trend, but we don’t know if there is an actual outbreak or just better reporting.”

Still, one case – like Carter's – is one too many, Myrick said. That’s especially true for a disease that can be prevented with a vaccine.

“That’s something I know and understand personally,” Myrick said. “A year and a half ago, when my wife went to a hospital to give birth to our son, Andrew, the first thing our OB/gyn asked was if she had been vaccinated for pertussis.”

Vaccinations

The sad part of losing a child to pertussis is that it is totally preventable with vaccinations, Myrick said.

Potter said pertussis is covered by the three-way DTap (diphtheria/tetanus/acellular) vaccine for children under age 7. Older children, teens and adults are covered through the three-way Tdap vaccine. There is no standalone pertussis vaccine.

He said infants get three doses of the vaccine at 2 months, 4 months and 6 months, but aren’t fully protected until they are 7 to 8 months old.

The first two shots are considered primers to build up the immune and antibody responses to the third dose.  

“And that’s if the children come in on schedule to get vaccinations,” Potter said.

Potter said many people assume the pertussis vaccine or a natural infection gives you a lifelong immunity to whooping cough, but that’s not the case. The protection wears off in five to 10 years, making it more likely that older children, teens and adults will contract the infection.

Dr. Alan Fleischman, senior vice president for the March of Dimes, said family members are responsible for spreading the disease 80 percent of the time, and, more specifically, parents are responsible 50 percent of the time.

Potter said anyone between the ages of 10 and 64 who is going to have direct contact with a baby under 12 months of age should be vaccinated against pertussis.

This includes household members, caregivers, daycare workers and health-care workers.

“In the six years I’ve been in the EMS field, I never heard of it actually happening until it happened to us,” Daryl said. “I mean, you read about it in textbooks, but that’s about it.”

Myrick said women should get the booster shot before becoming pregnant, but can also receive it during pregnancy or while giving birth.

“They (babies) don’t get it (pertussis) from the shopping mall or grocery store. An infant that age isn’t going to be out in those types of environments,” Potter said.

Nothing will bring Carter back, but the Dubes are talking to anyone who will listen.

“To think, all of this can be prevented with a simple booster shot,” Felicia said. “The thought never entered our minds that Carter wouldn’t be going home with us.”    

Sounds of Pertussis campaign 

The Dubes never intended to take Carter’s story public, but after learning how many people are uneducated about pertussis, they changed their minds. They have posted a video diary of Carter at http://www.youtube.com/watch?v=2u0dnlDSo0g.

“Sharing the photos has been the hardest thing,” Felicia said. “Unless you’ve seen it, you don’t realize how hard it is to see a 7-week-old hooked up to a heart bypass machine. You don’t ever forget those beeping sounds of machines that alert nurses.

“This time last year, you couldn’t have told us we’d be going through this,” she said, fighting back tears.  

Two of those listening are NASCAR driver Jeff Gordon and his wife, model Ingrid Vanebosch. The Gordons, who are expecting their second child, are working with the March of Dimes and Sanofi Pasteur to raise awareness of pertussis.

Gordon, the national spokesman for Sounds of Pertussis, was so impressed by the Dubes’ willingness to be honest and open that he rearranged his schedule in June to spend the day with them at the 24/48 Hendrick Motorsports shop.

Felicia said she was stunned to learn the Gordons knew Carter by name.

“Now, with a new baby on the way, we’re not taking any chances – we’re getting vaccinated,” Gordon said. “I’ve already rolled up my sleeve and Ingrid will get her immunization shortly after our son is born.”

Felicia said she hopes the Gordons will become the voices that she, Daryl and other parents who have lost a child to pertussis can’t be.

Felicia said what happened to Carter can happen to anybody. Some chances just aren’t worth taking.

“We take a chance with our lives every day when we get into a car to drive anywhere,” she said. “So why wouldn’t you take the booster shot that could save a life, possibly of someone you know and love?”

 

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