Cases of whooping cough have been steadily on the rise in the U.S. since a low of about 1,000 cases in 1976, and in 2004, the latest year for which data are available, more than 25,000 cases were reported, the largest number since the 1950s, according to a press report.
Most cases of whooping cough in the U.S. today are diagnosed in adults, said Dr. W. Paul McKinney, associate dean of the School of Public Health and Information Sciences at the University of Louisville. He’s also a former staff member of the federal Centers for Disease Control and Prevention and serves on the agency’s advisory committee on immunizations.
“It gets misdiagnosed an awful lot in adults” because families and physicians aren’t thinking about whooping cough in grown-ups, McKinney added. “I think there is confusion about what it looks like in adults and the severity of the diseases, how disruptive it is to individuals and families, and how it impairs performance.”
McKinney noted differences in the response to the infection depending on the age of the patient.
“Classical whooping cough is a disease of young infants that can cause them brain injury and neurological injury. The respiratory gasp for breath that makes the whooping noise can mean not enough oxygen is getting into the blood,” he said. Low oxygen content in blood can damage the brain.
The pattern in adolescents and adults differs. “They will have a protracted, hacking cough that may or may not be productive that goes on for a month or six weeks, interfering with sleep. It can cause broken ribs,” McKinney explained. “It can cause pneumonia.”
Other public health problems:
* The whooping cough vaccine you receive as a child wears off about age 11.
* Adolescents and adults can get the disease and cause outbreaks.
The Centers for Disease Control and Prevention said that 2% of adults ages 18 to 64 got a booster shot for whooping cough in the two years since the vaccine hit the market. The combo whooping cough booster, called Tdap, should be given every 10 years, doctors say.
– by Gene J. Koprowski, Editorial Director
For more information, see,
http://www.courier-journal.com/apps/pbcs.dll/article?Date=20080207&Category=FEATURES03&ArtNo=802070318&SectionCat=FEATURES&Template=printart

Pathogenesis of whooping cough — known in medicine as Bordetella pertussis.
Posted: February 11th, 2008 under Feature Stories, Whooping Cough.
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