PUBLISHED: 4:51 PM on Wednesday, July 30, 2008
Whooping cough can now be reduced in our community
Three recently reported cases of Whooping Cough in Southeast Alaska bring us opportunity for reducing future cases. Whooping Cough (the scientific name is Pertussis for the bacteria, Bordetella pertussis, which causes it) is a vaccine-preventable disease that lasts for many weeks. It is more severe in children, especially those not vaccinated, with repeating spasms of severe coughing, whooping and vomiting after coughing.

Whooping Cough can be effectively treated with antibiotics like Erythromycin, but is often missed in early stages which make treatment slower to take effect. Because a vaccine for older persons was not available until 2005, studies have shown older persons are often the source of infection of children. (State of Alaska Epidemiology Bulletin, October 24, 2007) Middle school and young adults have been found to be the reservoir of the germs because the vaccine could not be given after 6 years of age until the FDA(Food & Drug Administration) licensed the new vaccine in 2005.

Whooping Cough is most dangerous to small infants. The repeated coughing with thick mucous secretions is dangerous to their small airways and taxing to their muscles and energy. There were 13 child deaths in the United States in 2003, most among those less than 4 months or older unvaccinated children. (Center for Disease Control and Prevention, October 13, 2005) The Alaska Epidemiology Bulletin reported in October 2007 there were almost 26,000 cases of Pertussis in the United States in 2004. Because Pertussis cases began to rise, year after year in the mid-1980s, this was the highest number of cases since 1959. There were 159 Alaska cases reported in 2005 and 91 Alaska cases in 2006. The new vaccine now licensed for older children and adults first began to be given to Alaskans in January 2006.

Vaccine for Pertussis, DPT (Diphtheria, Pertussis, Tetanus) has been given for many decades to children between 2 months and 6 years of age. The Pertussis part was modified in the mid-1990s to reduce redness, swelling, pain and fever from the older vaccine. It was then called DTaP (Diphtheria, Tetanus, acellular Pertussis). The newest vaccine Tdap (Tetanus, low dose Diphtheria, acellular Pertussis) can now be given safely from 11 through 64 years of age. This means the reservoir of Whooping Cough among older children and adults can be reduced.

Alaska provides Tdap as Adacel (trade name by vaccine producer, Sanofi) because it includes vaccines for both Diphtheria and Tetanus, a single dose of Tdap should be given for the previously recommended Td (Tetanus, low dose Diphtheria) vaccine. The table below shows the recommended vaccine, common name, and age group for use in Alaska.

The reservoir of Whooping Cough cases among teens and adults continues to cause severe illness among infants and small children. With more use of the new Tdap vaccine, infants and children will be at lower risk of exposure. The vaccine is available, from the State of Alaska Division of Public Health, in family and adult physicians' offices as well as the offices of pediatricians and the State of Alaska Public Health Clinics. Physicians' offices charge for the costs of administration. Public Health Clinics also have charges for administration for those over 18 years. Costs for administration can be reduced or waived in needy cases. Please contact your family physician or your Public Health Clinic to receive Tdap as soon as possible, if you have not recently been immunized against Whooping Cough. You will be protecting all the infants in your community.

Dr. George W. Brown is a pediatrician with Glacier Pediatrics and is on Bartlett Hospital's medical staff.