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What is pertussis? Whooping cough, and it’s preventable

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Are you at risk for developing whooping cough, also known as pertussis? You may be unaware that the incidence of this illness has increased in both Oregon and the nation. However, you can prevent it with improved vaccinations and boosters.

Background
The name pertussis (intense cough) was first coined by Thomas Sydenham in 1670. The name pertussis is preferable to whooping cough because most infected individuals do not "whoop." The cause of the illness is a toxin, produced by a bacterium called Bordetella Pertussis that is found in the mouth, nose and throat of an infected person. Pertussis can occur at any age. In Oregon, from 2000 through 2010, approximately 60 percent of the pertussis patients were 10 years of age or older. Hospitalization and death from pertussis (4 in the past 5 years) have been limited to those under 1 year of age.

Symptoms
Early symptoms frequently include a runny nose and low-grade fever with a mild cough. Later, as the disease progresses, paroxysms (fits) of coughing occur, sometimes followed by a whooping sound as the child tries to breath. Vomiting, disturbed sleep, weight loss, incontinence, rib fractures and occasionally passing out from episodes of violent coughing can occur.

Pertussis in 2010
In 2010, 27,500 cases of pertussis were reported in the US, but many more go undiagnosed and unreported. California alone reported more than 9,000 of these cases, more than the state had seen since 1947. Of these, 89 percent occurred in infants younger than 6 months, a group too young to be adequately immunized and largely dependent on herd immunity for protection from infection. Ten of these infants died from their infection.

Vaccines
Vaccines containing tetanus toxoid, diphtheria and acellular pertussis, in the form of DTaP for children between 6 weeks and 6 years of age and Tdap, available since 2006 for ages 10 through 64 and more recently for 65 and above, provide immunity against pertussis as well as diphtheria and tetanus.

Importance of vaccines
The United States saw as many as 200,000 cases of diphtheria and pertussis and hundreds of cases of tetanus before these vaccines became available. Since then, tetanus and diphtheria cases have dropped by about 99 percent and pertussis cases by 97 percent thanks to vaccinations. In fact, during the pre-vaccine era of 1922-1948, pertussis was the leading cause of death due to communicable disease among children less than 14 years of age.

The pivotal role of vaccines in disease control is reflected in the continued high incidence of pertussis in developing countries, and resurgence in other countries where vaccine coverage is low or where less potent vaccines are used. As a result, 30-50 million cases of pertussis occur worldwide each year, resulting in more than 300,000 deaths.

Today, universal pertussis immunization of children younger than 7 years of age, beginning in infancy is essential in controlling pertussis. Adult vaccination with Tdap is recommended for those who come in close contact with infants, such as grandparents, childcare and healthcare providers and pregnant women. Pregnant women who have never had a dose of Tdap, should get one after the 20th week of gestation and preferably during the third trimester.

Despite the phenomenal success of childhood vaccination, thousands of U.S. parents refuse selected vaccines or delay their administration on either religious or philosophical grounds. Others believe that the benefits of at least some immunizations don't justify the risks. Since parents today have little or no experience with vaccine-preventable diseases, such as polio, hemophilus influenza type b (Hib) or measles, they can't easily appreciate the benefits of vaccination or the risks of not vaccinating.

In this age of information or misinformation, sources such as television and the Internet spread rumors more often than facts. In my opinion, the beneficial evidence speaks for itself and is not open for debate!

Independent and progressive, Oak Street Medical provides a unique combination of complementary health care services that includes Primary Care, Diabetes and Mental Health, as well as Allergy, Asthma and Immunology through Oregon Allergy Associates.