Friday, February 13, 2009
Pertussis (Whooping Cough)
Pertussis, commonly known as whooping cough, is a highly contagious disease that can last for weeks and typically causes severe coughing fits. It is caused by the bacteria Bordetella pertussis and can be prevented with a vaccine. After the introduction of the vaccine for pertussis in 1940, incidence for the disease decreased by over 99 percent to a low of 1,010 cases in 1976. Recently, the trend has reversed with a peak of 25,000 cases in 2005 and more than 15,000 in 2006. Two-thirds of reported cases in 2005 were in adolescents or adults. Reasons for this increase include under-vaccination in infants, under- and misdiagnosis of pertussis in the past, decreased immunity from past vaccinations, and increased recognition of cases in adolescent and adult populations.
Pertussis is most severe in children under one year of age. From 2000 to 2004, 90 percent of the total 100 deaths related to pertussis occurred in infants less than four months old.
The CDC’s Advisory Committee on Immunization Practices (ACIP), the Committee on Infectious Diseases of the American Academy of Pediatrics and the American Academy of Family Physicians all recommend that children (6 weeks to 6 years old) routinely receive five doses of a combination vaccine, DTaP (diphtheria and tetanus toxoids plus a cellular pertussis vaccine) at the ages of 2, 4, 6, 15 to 18 months, and 4 to 6 years. ACIP also recommends that children 11 and 12 years of age receive a single dose of Tdap (tetanus, diphtheria and pertussis) instead of the usual diphtheria and tetanus booster. Recommendations also call for older adolescents (13 to18 years old) to receive a single dose of Tdap if they have not yet received a Tdap vaccination. Adults under 65 years of age are encouraged to receive one Tdap vaccination instead of a Td (tetanus and diphtheria) booster. Tdap is comprised of two vaccines and is licensed for use in adolescents and adults ages 10 to 64 years.