Making the case for the pertussis vaccine
June 30, 2012
Many people who were vaccinated against whooping cough may not know that the vaccine's protection does not last forever. According to the Centers for Disease Control and Prevention (CDC), the rates of whooping cough have been increaseing in adolescents and adults and they in turn may give the infection to infants.

"Whooping cough" may be considered by people to be more of a comical name for a disease than a frightening one, but they shouldn't think that. Whooping cough or its scarier medical name, Bordetella Pertussis, worldwide kills about 200,000 babies a year.

Pertussis starts out with the same symptoms as does a cold: a runny nose, a low fever and, maybe, a cough. The symptoms can last for one to three weeks during which time the patient is very contagious. The disease is transmitted through secretions from the lungs or droplets from sneezing or coughing. Bursts of rapid coughing come after the cold symptoms and may last up to three months. Sufferers can turn blue and vomit. The whooping sound comes from trying hard to get air to breathe.

Babies between 6 to 12 months old are at highest risk for serious illness and may not have a cough early on but may stop breathing. They can suffer brain damage or die. Recovery for those without permanent damage may take weeks to months to occur.

A laboratory test might be performed to identify the disease but the usual treatment by a doctor is administering antibiotics based upon the level of illness. People who have come in contact with pertussis should be treated within three weeks of exposure.

The vaccine against pertussis was introduced in the 1940s, after which the number of cases in the United States fell. This original vaccine required multiple doses and offered protection against the disease for 5 to 10 years.

Reported cases of pertussis vary from year to year and tend to peak every 3-5 years. The CDC reports that in 2010 27,550 cases of pertussis were reported in the U.S. but cautions that many more cases simply go unreported. Twenty-seven deaths were reported 25 of these deaths were in children younger than 1 year old. Since the 1980s, there's been an increase in the number of cases of pertussis, especially among teens (1019 years of age) and babies younger than 6 months of age. In 2010, an increase in reported cases among 7-10 years old was seen. This new trend reinforces the need for a routinely recommended booster dose of Tdap at age 11 or 12 years.

Since the vaccine does not last forever, the CDC also now recommends a one time booster shot for teenagers and adults in addition to the series of vaccines given babies and children.

If we can improve our vaccination rates, we can stop the spread of this preventable, deadly disease.

Commentary by Dr. Wayne Meyer, medical director, Anthem Blue Cross and Blue Shield in Missouri

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