How can I protect myself and my family?
The best protection is through the use of a vaccine against Pertussis. Before the introduction of Pertussis vaccination in the 1940s, Pertussis was a major cause of serious illness and death among infants and young children in the United States. An average of more than 160,000 cases and more than 5,000 deaths were reported every year in the 1920s-30s. At its peak during this period, the annual number of case-reports was more than 250,000 with up to 9,000 deaths. In the 1940s, whole-cell pertussis vaccine combined with diphtheria and tetanus toxoids (DTP) was introduced, and case-reports of Pertussis decreased more than 99% by 1976, when the number of reported cases reached a record-low of 1,010 cases.( source CDC).
Unfortunately the number of cases of Pertussis has been gradually increasing since the early 1980s. A total of 25,827 cases were reported in 2004, the largest number since 1959. The definitive reasons for the increase are not clear but we do know that vaccine effectiveness is not 100% and protection can wear off in time.

Who should get vaccinated?
Everybody in the family should be immunized against whooping cough to protect themselves. Make sure that your children are up to date with their immunizations. Pertussis vaccinations (DTaP) are given to children at 2 months, 4 months 6 months, 18 months and 4-6 years of age. Prior to 2005 we did not immunize adolescents and adults against Pertussis. In 2005, two new tetanus toxoid-diphtheria-acellular pertussis (Tdap) vaccines were licensed for use in adolescents and adults age 10-64. These vaccines are the first pertussis-containing vaccines that make it possible to vaccinate adolescents and adults against pertussis. The Tdap vaccine is given as a single booster dose.

When should I receive the Tdap vaccine?
It is recommends that adults 19 through 64 years of age receive a single dose of Tdap to replace a single dose of Td for booster immunization against tetanus, diphtheria and pertussis if the most recent tetanus toxoid-containing vaccine was received at least 10 years earlier. Adults in close contact with an infant aged under 12 months who have not previously received Tdap should receive a dose of Tdap as short as 2 years since the most recent Td is suggested. Contact your healthcare provider to determine if you should receive a Tdap vaccine at this time

Where can I obtain more information?
The Center for Disease Control and Prevention has an excellent website related to Pertussis at http://www.cdc.gov/vaccines/vpd-vac/pertussis/default.htm

by Dr. Ronald Frank
Middlesex, NJ

What is Pertussis?
Pertussis or whooping cough is a contagious respiratory infection caused by the bacteria Bordetella pertussis. The disease is divided into 3 stages; the first stage begins with mild cold-like symptoms and possible fever. This stage can last 1-2 weeks before developing into the second stage which has characteristic symptom of bursts of numerous, rapid coughs. At the end of the cough the patient suffers from a long inhalation effort that is characterized by a high-pitched whoop thus leading to the name whooping cough. The coughing spasms may lead to vomiting, loss of breath and exhaustion. This second stage can last up to 10 weeks. Children and young infants, especially, appear very ill and distressed. Young infants are at the highest risk for developing Pertussis related complications and death. Adolescents and adults usually have a milder course, although these individuals are still able to transmit the disease to others, including unimmunized or incompletely immunized infants. The last stage usually lasts 2-6 weeks where recovery is gradual and the cough becomes less paroxysmal. However, paroxysms often recur with subsequent respiratory infections for many months after the onset of Pertussis. The long duration of symptoms is why Pertussis is sometime referred to as the 100 day cough.

How is Pertussis transmitted?
Pertussis is a human disease. The organism is transmitted by close contact of aerosolized droplets from patients with the disease. It may take 5-21 days after contact to develop an infection. It is most contagious during the first stage and the first 2 weeks after cough onset. This disease is commonly transmitted from adults to children.

Can Pertussis be treated?
Antibiotics can be helpful in the treatment of the disease when given early in its course. Household and other close contacts will usually be treated as well to help prevent them from developing the disease.