U.S. Pertussis, Whooping Cases Climb

In 2004 the number of pertussis cases grew to nearly 19,000 and, for the first time in the United States, there were more cases of whooping cough reported in adolescents and adults than in infants. Health experts say that, since immunity doesn't last, boosters shots should be taken by older children and adults every 10 years. Richard Knox reports.

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There's another new vaccine that's aimed at older children and adults. It protects against a disease that most adults and their doctors think of as a threat to their young children: whooping cough. NPR's Richard Knox reports.

RICHARD KNOX reporting:

Classic whooping cough, known to doctors as pertussis, sounds like this.

(Soundbite of infant with pertussis)

KNOX: But these days, it's more likely to sound like this.

(Soundbite of adult with pertussis)

KNOX: That's Dr. Michael Pichichero of University of Rochester Medical Center demonstrating an adult whooping cough fit. Pichichero says infants can literally suffocate from such fits. Adults rarely die from whooping cough, but that doesn't mean it's trivial.

Dr. MICHAEL PICHICHERO (University of Rochester Medical Center): Sometimes that spasm of coughing can be so severe that they break ribs or vomit at the end of the coughing or find themselves almost breathless.

KNOX: After a week of coldlike symptoms, teen-agers and adults often feel fine--between coughing fits, that is--but the cough and the sleeplessness it causes often cost days or weeks of school or work.

Dr. PICHICHERO: In China, they call whooping cough the 100 days cough, because even after the worst is over, there are a substantial number of individuals who keep coughing for a little beyond three months. To me, that's a pretty darn significant illness.

KNOX: Officially, there are nearly 20,000 cases of whooping cough every year, but experts say the real number is as many as two million in teen-agers and adults alone. Those cases now outnumber whooping cough infections in infants. Whooping cough ruined Zack Villerdell's(ph) summer. He's a 13-year-old trumpet player in Crestwood, Kentucky.

ZACK VILLERDELL (Trumpet Player): Well, it started when I was at camp, and I had been coughing all night and I couldn't stop.

KNOX: Zack kept on coughing after his family picked him up to go on vacation. Then they got a message from his pediatrician saying a girl in his church had come down with pertussis.

VILLERDELL: And he wanted us to get me tested. We were in North Carolina by now. They wouldn't test me for it there, because they didn't believe that I had it.

Ms. SHEILA VILLERDELL(ph) (Mother): The doctor that we saw in the emergency room told me straight out that if he'd been vaccinated as a child, there's no way that he could get it.

KNOX: Sheila Villerdell is Zack's mom.

Ms. VILLERDELL: And he didn't have the kind of cough that this doctor associated with whooping cough. So he sent us home.

KNOX: Dr. Michael Dworkin of the Illinois Department of Public Health says this is a familiar story.

Dr. MICHAEL DWORKIN (Illinois Department of Public Health): Unfortunately, there's a number of myths about pertussis. Adults don't get it. Well, adults do get it. And another one is that if you're immunized, then you're protected. And, in fact, you could be fully immunized but a number of years have elapsed and so your vaccine immunity is just not strong enough.

KNOX: That's the reason for the new vaccine. Actually, federal authorities approved two new pertussis vaccines for teen-agers and adults this summer. A federal advisory committee recommends all kids from age 11 through the teens get the booster shot. It'll cost about $35 and, because it's officially recommended, many insurance plans will pay for it. The government's vaccine advisers are still pondering whether to recommend whooping cough boosters for adults. Pichichero, the Rochester doctor, hopes they will, because giving booster shots to adults and teens will protect infants. Babies under six months old are vulnerable because they haven't completed their series of three pertussis vaccine shots.

Dr. PICHICHERO: One of the strategies that's being considered by the government would be to vaccinate all adults who care for children below six months of age. So this would be mothers of such children and grandparents of such children, so that they could not carry the whooping cough germ and transmit it to these highly vulnerable babies.

KNOX: Vaccinating adults to protect infants is called cocooning. But Pichichero doesn't want to stop with immunizing infant caregivers. He's urging his adult children, his middle-aged brothers and his 84-year-old mother to get the whooping cough booster. He says soon, many doctors will combine the pertussis vaccine with boosters for tetanus and diphtheria.

Dr. PICHICHERO: With the current shots as available today, we are expecting that about every 10 years, you not only will need a tetanus booster but you'll also need a whooping cough booster.

KNOX: And this all-in-one booster will be called a TDaP shot. Richard Knox, NPR News.

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