• Pertussis (Whooping Cough)

    Pertussis, or whooping cough, is a highly contagious bacterial respiratory tract infection. Nationally, pertussis is on the rise among all age groups, with more than 20,000 cases identified in the United States in 2005. However, the vast majority goes unreported, and some experts believe there may actually be up to one million cases every year.

    Symptoms of pertussis in adults range from a mild coughing illness to classic pertussis, (e.g., prolonged severe coughing spells, post-cough vomiting, and a whoop sound while gasping for breath during a coughing spell). Complications from pertussis include rib fractures, resulting from severe cough, and pneumonia.

    Children routinely get a series of five vaccinations against pertussis. The vaccine's effectiveness decreases within five to ten years. As a result of this, pertussis now more commonly affects young adults and the elderly. Adults with pertussis can transmit the infection to others, including infants, who are at the highest risk of pertussis-related complications and death compared with older age groups.

    Health care workers are also at risk, both for acquiring infection and transmitting it to others. Recently, there have been news reports of pertussis outbreaks in local hospitals. A single outbreak can result in substantial disruption and costs to a hospital and its employees.

    Pertussis is most contagious before the coughing begins, so the best way to prevent infection is through vaccination. In 2005, the Federal Drug Administration (FDA) approved the first pertussis booster shot for adults and adolescents. The booster vaccine is called Tdap, which stands for tetanus-diphtheria-acellular pertussis. Tdap protects against tetanus, diphtheria and pertussis, three diseases that need boosting over the years. Public health officials now recommend that adolescents and adults receive a single dose of Tdap to protect against pertussis, instead of the previously recommended Td (tetanus-diphtheria) booster.

    It is especially important for those in contact with infants younger than 12 months of age to receive the vaccine. When possible, women should receive Tdap before becoming pregnant. Pregnant women who have not been previously vaccinated should receive a dose of Tdap in the immediate postpartum period.

    Health care personnel who work in hospitals or ambulatory care settings and have direct patient contact should receive a single dose of Tdap as soon as possible if they have never received it before. An interval of two years from the last Td is suggested, but shorter intervals can be used. Adverse reactions to the vaccine are rare.

    Ask your doctor about receiving the Tdap vaccine to protect against pertussis at your next scheduled appointment.
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