Spread of Whooping Cough Raises Concern08/04/10
WEDNESDAY, Aug. 4 (HealthDay News) -- Amidst the largest
outbreak of whooping cough in decades, public health officials in
California are urging residents, particularly pregnant women and
those who come into contact with infants, to make sure they're
immunized for the highly contagious disease.
With the incidence of whooping cough also higher than last year
in Michigan, South Carolina, Ohio and upstate New York, there's
growing concern whooping cough will continue to spread, said
Jennifer Liang, an epidemiologist with the U.S. Centers for Disease
Control and Prevention. Whooping cough, or pertussis, is named for
the wheezing sound, or "whoop," sufferers make when they try to
breathe during a coughing fit.
"Pertussis is a cyclic disease, and we do see peaks every three to five years," Liang said. "The last peak was 2005, when we had 25,000 reported cases nationally, and we may be on the upswing of another cycle."
So, should you be worried? In adults, whooping cough can cause a
barking cough that lasts for weeks, but it's treatable with
antibiotics and rarely life-threatening, said Jeff Dimond, a CDC
But in infants too young to be immunized, whooping cough can be
deadly. Last week, the seventh California baby died in what public
health officials are called the largest outbreak in 50 years.
About two-thirds of infants who get pertussis will be
hospitalized, according to the CDC. About one in 10 children who
are infected develop pneumonia, while in one in 250 get the disease
that affects the brain, called encephalopathy.
In the first half of the year, California has seen nearly 1,500
reports of pertussis. That compares to a little more than 300 cases
in the first part of 2009, according to the California Department
of Public Health.
As for the smaller outbreaks in other states, Liang cautioned
that reporting by local and state public health departments varies
widely, so the CDC's national surveillance data can lag. Local
health departments tend to be more attuned to localized outbreaks,
"The magnitude of the increase in California is concerning, and that's why we are trying to emphasize the importance of vaccination," Liang said.
Vaccination guidelines call for children to receive doses of
pertussis vaccine at 2 months, 4 month, 6 months, between 15 and 18
months and then again at school age, between 4 to 6 years. Children
should also receive a booster between the ages of 11 and 12.
Previous recommendations called for women to get vaccinated
right before or right after pregnancy to protect infants. But in
the wake of the epidemic, California public health officials are
now advising pregnant women to get vaccinated.
Since 2005, the CDC has also recommended adolescents and adults
up to age 64 receive a one-time booster shot because immunity from
childhood pertussis immunization wanes over time, said Christina
Chambers, an epidemiologist and a professor of pediatrics at the
University of California, San Diego.
The shot itself, called Tdap, typically also includes a tetanus
and diphtheria booster.
Yet few adolescents and adults are following expert
recommendations, Liang said. A 2008 CDC study found about 40
percent of adolescents aged 11 and 12 had gotten the booster, while
only 6 percent of adults had.
Though there little data explicitly looking at whether the
vaccine is safe for pregnant women, there is no evidence that
getting the vaccine can bring on the disease or carries any other
risks. The pertussis vaccine is made up of an inactivated, or
"killed," virus, Chambers explained.
"There is no data to suggest [that] giving the pertussis vaccine during pregnancy will cause harm," said Chambers, director of the California Teratogen Information Service (CTIS) Pregnancy Health Information Program, which provides counseling for pregnant women on the safety of exposures to medications and vaccines.
Chambers added: "Though it's not a 100 percent guarantee, that's
reassuring. And there is definitely concern about the mother
getting the disease and the infant not being protected."
Adults who will be around infants and other family members
should also make sure they get vaccinated or booster shots, Dimond
said. "You make a cocoon around an infant so people coming into
contact with the infant don't spread it," Dimond said.
Peak season for whooping cough is late summer and early fall.
The disease usually begins with symptoms similar to those of a
common cold, such as runny nose, congestion and a mild fever, and
then progresses to a dry, hacking cough and prolonged, violent
coughing spells that can cause vomiting.
CDC has more on the pertussis vaccine.
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