Whooping Cough Increasing Among Teens

Most Parents Don't Know Vaccine Protection Wanes, Survey Shows

From the WebMD Archives

Oct. 21, 2004 -- Whooping cough is still alive and well contrary to what most parents think.

Betty May Graham first thought her 14-year-old son, Zach, had a bad cold or the flu when his coughing began two autumns ago. Within a few weeks, though, the coughing fits became so violent that he would frequently vomit after having one.

"One morning he was coughing so hard he was having trouble breathing. That is when I got really scared," she tells WebMD.

When a pulmonary specialist diagnosed whooping cough, known medically as pertussis, Graham says she was shocked.

"He had had all of his shots as a baby, and I just assumed that he was protected," she says.

Whooping Cough Outbreaks Increasing

Graham is not alone. A newly published survey shows that fewer than one in five parents of teens questioned considered whooping cough an illness of concern, despite the fact that outbreaks in middle and high schools have increased in recent years.

"Parents tend to think that if their kids have been vaccinated they don't have to worry, and while that is true for younger children, it isn't true for teens and young adults," adolescent medicine specialist Amy Middleman, MD, of Baylor College of Medicine in Houston, tells WebMD.

The current pertussis immunization schedule calls for five doses of vaccine to be given by age 6, and protection typically lasts between five and 10 years after the last dose of vaccine is given. The decreased immune protection as the vaccine wears off leaves many teens unprotected against the illness.

In the survey, conducted by the Society for Adolescent Medicine, just 15% of parents questioned could accurately identify the duration of protection for whooping cough.

Despite increasing vaccination of infants and young children, the diagnosis of whooping cough has nearly tripled over the last two decades. This is partly due to better ways of identifying the disease, but it is also due to a real increase among adolescents and young adults, experts say. Almost 40% of whooping cough cases reported in 2003 occurred in children between the ages of 10 and 19, according to figures from the U.S. Centers for Disease Control and Prevention. In 2003 there were 11,000 cases of whooping cough reported to the CDC, the highest reported in nearly 40 years. One thousand cases of whooping cough were reported in 1976.

Booster Vaccine

The U.S. Food and Drug Administration is now considering a proposal to add pertussis to booster vaccines now given to 11- and 12-year-olds. Pediatric infectious disease specialist Sarah Long, MD, says the move could be an important step toward protecting teens and highly vulnerable infants who have not yet been fully vaccinated.

"We are looking at the data right now to get a better understanding of the safety and efficacy of doing this," says Long, who is a spokeswoman for the American Academy of Pediatrics.

While whooping cough is rarely life threatening in teens and young adults, spasmodic coughing fits often last for months and can dramatically impact daily life. Outbreaks occur rapidly as a result of being exposed to an infected person.

Zach Graham, who lives in New Hampshire and is a competitive downhill skier, says it took him almost five months to feel normal again after his bout with whooping cough. Early on, his mom says, he had coughing fits that led to vomiting as many as 18 times a day. And even after the racking coughing subsided, lingering weakness caused him to miss much of the ski season.

"My goal was to be on the Junior Olympic team," says Zach, who is now 16. "My coaches and I agreed that I could do it if I set my mind to it, but then I came down with whooping cough. It took so much out of me that there was no way I could train at the level I needed to."

Show Sources

SOURCES: Survey conducted by Society for Adolescent Medicine. Amy B. Middleman, MD, MPH, assistant professor of pediatrics, Baylor College of Medicine, Houston. Sarah Long, MD, spokeswoman, American Academy of Pediatrics; chief of infectious diseases, St. Christopher's Hospital for Children, Philadelphia. Zachary Graham, Sunapee, N.H. Betty May Graham, Sunapee, N.H.
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