CDC: Whooping Cough Is Back
Cases Rising -- but Often Not Recognized -- in Teens, Preteens
Dec. 22, 2005 -- Whooping cough is making a big comeback, especially among
teens and preteens.
That's the word from the CDC -- and the disease-tracking agency says states
are woefully undercounting whooping-cough cases.
Even so, a report in the Dec. 23 issue of the CDC's MMWR shows that
cases are on the rise. Whooping cough -- pertussis, to doctors -- hit a
historic low of about 1,000 cases in 1976. Since then, the numbers have been
getting much worse. In 2003, there were 11,647 cases.
But these numbers almost certainly are too low. For example, Massachusetts
tries much harder than other states to count cases. That state has only 2% of
the U.S. population. But it reported 19% of all cases in kids aged 11-19.
"Awareness of pertussis in adolescents … is still low in many
places," notes a CDC editorial. "Massachusetts data are believed to
more closely reflect the pertussis burden in the United States."
In fact, a report earlier this year in The New England Journal of
Medicine predicted that about occur among teens and adults in the U.S. each year. In older
children and adults, whooping cough may be mistaken for bronchitis.
Recently doctors realized that the childhood whooping cough vaccine wears
off by adolescence. That leaves preteens and teens vulnerable to the disease --
and able to spread the infection to their far more vulnerable infant
Last summer, the U.S. recommended a whooping cough/tetanus/diphtheria
booster shot for everyone aged 11-18. It's hoped that this will reverse the
rising tide of cases.
A Nasty Disease
Whooping cough isn't pretty. The symptoms include violent attacks of
coughing, often followed by vomiting. The "whoop" part comes when the
coughing attack subsides, and the patient finally takes a huge, whooping
While deaths are rare, infants, particularly those who get the illness
before their first vaccination at age 2 months, are more susceptible. Despite
the rise in cases among teens, infants still bear the brunt of the disease.
More than 90% of whooping cough deaths are in infants younger than 6 months.
Three-fourths of whooping-cough deaths are in babies younger than 2 months.
Kids get a combination pertussis/tetanus/diphtheria vaccine at ages 2
months, 4 months, 6 months, 15-18 months, and 4-6 years. The new shot should be
given at age 11-15 if it has been five years since the last booster.
"Ensuring high coverage with [tetanus/diphtheria/pertussis vaccine] in
adolescents is an important step to better control pertussis in the United
States," the CDC says.