Sunday, November 22, 2009
News, Health + Fitness, Atlanta
Whooping cough makes a comeback
Public health records show the number of pertussis cases in Georgia in the first half of this year more than doubled last year’s
One-month-old Zane Flavell recovers from Whooping Cough in the arms of his dad, David Snook. On the bed is his brother Marley.
Bastiaan Beentjes/Getty ImagesBy Christine Foster
Five years ago, 42-year-old Mark Judd thought he was coming down with a simple cold when he first felt that slight “tickle” in his throat.
Pretty soon, the tickle had become a full-blown cough that didn’t seem to improve with time. After a month of severe coughing bouts, Judd finally made an appointment with his doctor. The diagnosis shocked him: whooping cough.
“I thought whooping cough was a disease of the past,” he said. “I didn’t even realize pertussis was the medical term for it.”
Like Prohibition and sock-hop dances, we think of childhood diseases like whooping cough as ancient history. But if Judd’s story tells us anything, it might be time to change our thinking.
Pertussis, commonly known as whooping cough, is on the rise. And without a major push toward continued and updated vaccination, many fear that it will only continue to plague more people. That thought is cause for concern, considering children are among the most vulnerable and have a harder time recovering from the disease.
“Over the years we’ve seen an increase in cases of pertussis,” says Renee Watson, a registered nurse and manager of infection control for Children's Healthcare of Atlanta (CHOA). “As the trend in vaccination either declines or rises, the cases of pertussis do as well among children who are not immunized.”
While smallpox has been wiped out worldwide and polio is well on its way to eradication, whooping cough is making an unwelcome comeback, and the outlook isn’t pretty.
“It was much worse than any cold or cough I’d ever had,” says Judd, who didn’t fully get over the disease for six months after being put on a series of antibiotics. “There were times when the coughing brought me to my knees and left me gasping for my next breath.”
Whooping cough is a highly contagious respiratory disease that usually begins with common cold symptoms. Maybe you’ll get a runny nose or a low-grade fever, but then the illness develops into something more sinister. The harsh, spasmodic, hacking cough is constant.
Once you hear the sound that gives whooping cough its name, you’ll probably never forget it. In children, the gasp for air sounds much like a “whoop,” due to the fact that their respiratory systems are not fully developed. The disease can take weeks or even months to get over completely.
After the first reported case of whooping cough in Paris in 1578, the number of cases rose worldwide until a vaccine was developed during the 1930s. Incidence rates of the illness decreased with the advent of the vaccine. The lowest recorded number of cases in the U.S., 1,010, was reported in 1976, according to the Centers for Disease Control and Prevention.
And then something happened.
Vaccine immunity in adults and adolescents began to wear off, while some feared rumored or potential vaccine side effects and stopped immunizing their children against the disease. A lack of updated vaccinations has caused the number of cases nationwide to continue to increase since the early ’80s.
“This has been an evolving problem,” says Brian Nadolne, a doctor in Northside Hospital’s family medicine department. “Those who do vaccinate think one vaccination protects them forever. They don’t realize they need to get revaccinated.”
FRIGHTENING CONSEQUENCES
There’s currently a perfect storm of lagging immunity, which causes adults to catch the illness and pass it onto unvaccinated children or infants.
The CDC estimates between 5,000 to 7,000 new cases of pertussis emerge each year. 2005 was an especially bad year, as the number of cases reached epidemic proportions—a total of 25,616 cases in the U.S. were actually confirmed. The number dropped to less than half that in 2007, but Georgia’s cases in 2009 are worrisome.
Georgia Division of Public Health records show the number of whooping cough cases in Georgia in the first half of this year is more than double that of the same time period last year.
“Whooping cough still occurs, and it’s important to realize that it’s still out there,” says Nadolne, who educates patients and doctors about pertussis for the American Academy of Family Physicians (AAFP). “Most people don’t know there is something we can do about it.”
According to a survey conducted by the AAFP last summer, “more than three-quarters of adults (76 percent) didn’t know or didn’t think whooping cough remains widespread in the U.S.”
The reality of those statistics impacts children most of all.
According to Mayo Clinic research, when teens and adults have received proper treatment, most recover from whooping cough without complications. However, the CDC’s Parents’ Guide to Childhood Immunization offers some terrifying insight into the effects of whooping cough in children and infants: One in 10 will also develop pneumonia, One in 50 will have seizures or convulsions and one in 250 will suffer some type of brain damage.
In the U.S.,10 children died from the disease in 2007.
Non-immunized parents are the cause of most of the cases at CHOA, says Watson. In essence, those who are caring for children are actually passing the disease to them.
In addition to the pertussis vaccination given to babies, the CDC recommends that everyone—ages 11 to 64—get the relatively new “Tdap” booster shot every five to 10 years to protect themselves and the children they are around.
So if it reduces susceptibility and even helps prevent deaths, why wouldn’t someone want to vaccinate?
“There is some belief, not substantiated by science, that common vaccines lead to autism,” says Watson. “However, autism prevalence occurs at the same rate in immunized children as it does in non-immunized children.”
SP