Diseases
> Pertussis
Pertussis
Disease
"Whooping Cough"
Questions
and answers
for parents, health care professionals, and
people considering immunization
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Why do we vaccinate against “whooping
cough” or pertussis?
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How many cases of pertussis are reported
in the United States?
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Is pertussis reporting on the rise in the
U.S.?
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Why are we concerned about pertussis among
infants?
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How much has pertussis increased in reporting
among infants in the U.S.?
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Is there a change in the severity of pertussis
in infants?
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What can we do to prevent infants from getting
pertussis?
- What
is the recommended immunization schedule
with DTaP to prevent pertussis?
- Why
do we vaccinate against pertussis
(also called “whooping cough”)?
Pertussis
is a bacterial respiratory illness characterized
by severe spasms of coughing that can last
for several weeks or even for months. Pertussis
is usually spread from person-to-person through
close contact with respiratory droplets released
when a person coughs or sneezes. Before the
introduction of vaccination in the 1940s,
pertussis was a major cause of serious illness
and death among infants and young children
in the United States.
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How many cases of pertussis are reported
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.
Top
- Is
pertussis reporting on the rise in the U.S.?
An increasing
number of cases of pertussis have been reported
to the CDC since the 1980s. The increases
are greatest among adolescents (aged 10-19
years), but an increase is also seen among
infants younger than 5 months old. The reported
increases may reflect greater awareness of
pertussis to some degree. Even with the increase
in reports among adolescents and very young
infants, the number of reported cases is
more than 97 % lower than in the pre-vaccine
era.
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Why are we concerned about pertussis
among infants?
Infants under
the age of 12 months have more serious illness
from pertussis and they are more likely to
have complications and be hospitalized than
persons in other age groups. In the 1990s,
about two thirds of infants reported with
pertussis were hospitalized. Infants are
more likely to have pneumonia or convulsions.
Infants also are at greatest risk of fatal
pertussis. In recent years, 15 to 21 infant
deaths from pertussis are reported to CDC
annually.
Top
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How much has the
reporting of pertussis among infants increased
in the U.S.?
The
case-reports of pertussis among infants younger
than 5 months have been increasing since
the 1980s. This age group is too young to
be well protected by DTaP (diphtheria and
tetanus toxoids and acellular pertussis)
vaccine. For example, the number of case-reports
among infants younger than 5 months was about
600 per year in the early 1980s, and about
1,700 per year at the end of the 1990s. The
average reported rate among infants in this
age group increased more than 50% in the
1990s compared with the 1980s (the average
reported rate was 89 in the 1990s per 100,000
infants). By contrast, among infants aged
5 to 11 months, there was no increase in
the reported rate from the 1980s to the present.
(Data from
Supplementary Pertussis Surveillance System).
- Has
there been a change in the severity
of pertussis in infants?
No. The severity
of the pertussis illness among reported infant
cases was comparable between the 1980s and
the 1990s, judging from reported symptoms
and the proportion of patients hospitalized.
Although the number of cases reported among
infants younger than 5 months increased,
the illnesses were just as serious as they
were in the past.
Top
- What
can we do to prevent infants from getting
pertussis?
In
the U.S., we have the vaccine called DTaP
(diphtheria
and tetanus toxoids and acellular pertussis
vaccine). DTaP is safe and effective, and
prevents severe pertussis and death among
infants and young children. The best
way to protect infants from pertussis
is to give DTaP vaccine starting on time
at 2 months of age. Parents should vaccinate
their infant on-time (at 2, 4, and 6 months
of age) and complete all the recommended
doses of DTaP vaccine to best protect their
infant.
At least three
DTaP doses are needed to have the maximum
benefit from the vaccination. However, even
one or two doses of DTaP will provide some
protection against pertussis. Parents are
urged to make sure their infant receives
these doses on time.
Parents can
also help protect their very young infants
by minimizing exposure (close contact) with
persons who have cold symptoms or cough illness.
Coughing people of any age, including parents,
siblings and grandparents can have pertussis.
When a person has cold symptoms or cough
illness, they need to stay away from young
infants as much as possible.
- What
is the recommended immunization schedule
to prevent pertussis with DTaP?
DTaP (diphtheria
and tetanus toxoids and acellular pertussis)
vaccine is recommended for all infants at
2, 4 and 6 months of age. An additional dose
of DTaP vaccine is recommended at 15-18 months
of age and at 4-6 years of age. It is important
that young infants start their DTaP vaccination
without delay at 2 months of age.
For
more information on pertussis, consult: http://www.cdc.gov/nip/menus/diseases.htm#pertussis.
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