Whooping Cough Stages Comeback

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Whooping Cough Stages Comeback

September 11, 2001

WASHINGTON (AP) - Whooping cough is one of those diseases most people think is

history - but the dangerous germ that can

leave sufferers gasping for air is making a comeback.

The cough so strong it can break a rib once hit mostly babies and toddlers, but

now it's striking more and more

teen-agers and young adults. Apparently the whooping cough vaccinations

Americans get as babies eventually can wear off.

Here's the real risk: While older people usually recover, they can easily spread

the illness to infants too young for

vaccinations. Whooping cough can kill babies.

So experts warn new parents to keep infants away from anyone who's coughing,

even as scientists study whether millions

of Americans should start getting booster doses of whooping cough vaccine just

as many get regular tetanus shots.

The goal is to develop boosters for older children and adults so there's " a wall

of protection around the newborn baby, "

explains Dr. Decker, a Vanderbilt University professor who has studied

whooping cough, also called pertussis,

for 20 years.

He just joined vaccine manufacturer Aventis Pasteur, which is working to bring a

booster shot sold in Canada to this

country.

Pertussis is a bacterial infection that at first seems like a cold: a runny nose

and hacking cough, first at night and

then during the day. Coughing fits begin a week or two later, up to 15 coughs in

a row followed by a high-pitched

" whoop " as patients gasp for air.

Infants are more likely to turn bluish than whoop as they run out of air. They

can get pneumonia and become dehydrated

and malnourished.

For teens or adults, the severe coughing can cause vomiting or a hernia, even

break a rib.

Consider Decker's own experience. " I got it off my 15-year-old this January, and

I was coughing for three months, " he

said. " I could feel my throat closing up and tightening, and I started choking

and gagging. It was a revelatory

experience for someone who's written the words and not experienced the feeling. "

Often, though, older patients have a milder illness, just a nagging cough. So

they don't see a doctor, or it's

misdiagnosed as bronchitis, because pertussis testing is very difficult. Indeed,

a Vanderbilt study found about

one-fourth of teens and adults with prolonged coughs unknowingly have pertussis.

It's most contagious during the first

three weeks.

The Centers for Disease Control and Prevention counted 56,775 whooping cough

cases during the 1990s, a 51 percent

increase from the 1980s - and a rise that's continuing.

Last year, CDC had reports of more than 7,000 cases, and " we suspect there may

be 10 times that amount " because of

underdiagnosis in teens and young adults, Dr. Kris Bisgard, a CDC

epidemiologist, said.

That's still a far cry from the 250,000 Americans who once got pertussis

annually before vaccinations began in the

1940s. But it's far worse than 1980, when there were only about 1,000 cases a

year.

The biggest rise: CDC figures show for every 1 million 10- to 19-year-olds,

three got pertussis in 1980 vs. 70 cases per

million older children last year.

They in turn can infect vulnerable infants. Pertussis rose 37 percent among

babies in the 1990s, almost exclusively

among those younger than 4 months. That's when infants get their second dose of

pertussis vaccine, and protection begins

kicking in.

Today, Americans get their final dose of pertussis vaccine by age 6.

Studies show that giving one-third of the youngster's dose to teens and adults

boosts their immunity nicely, CDC's

Bisgard said. Canadians already can get just such a booster dose.

Americans can get booster doses of tetanus and diphtheria vaccine every 10

years. (You call it a tetanus shot, but the

two almost always come together.) The idea: Just add a pertussis booster to that

shot. After all, babies today get

diphtheria, tetanus and pertussis vaccine in the same shot, called DTaP.

Aventis and a competitor, GlaxoKline, both are studying boosters, Bisgard

says, and experts expect one will hit the

market in about two years.

For now, what's the advice?

Keep infants away from people who have any cough illness, Bisgard said - and

make sure they're vaccinated on time. DTaP

doses are given at ages 2, 4 and 6 months, again at 15 to 18 months and a final

dose between 4 and 6 years.

Copyright 2001 The Associated Press. All rights reserved