Your Health Matters
By Claudia Parks, R.N.

[Latin. Tussis, cough] When you see the root word tussis in a word or name- figure it has something to do with coughing! Robitussin®, Pertussin ES®, and many house brands will have tussin in the name of cough syrup. An antitussive is a medication "against coughing." The term, cough suppressant is being used more frequently these days. Now that you've had a word lesson, take the clue as to what disease Pertussis relates?

RIGHT! Whooping Cough. Known medically as pertussis- a highly contagious respiratory tract infection. Although it initially resembles an ordinary cold, whooping cough eventually turns much more serious. In the more advanced stages, it's marked by the symptom that gives the disease its name: a severe, hacking cough followed by a high-pitched intake of breath that sounds like "whoop."

These coughing spells don't just leave you gasping for air. They can be so violent they cause bruised or broken ribs and vomiting- even choking or a momentary loss of consciousness, especially in children and infants.

In the first half of the 20th century, whooping cough was a leading cause of childhood illness and death in the United States. But after the introduction of a vaccine in the 1940s, the number of cases gradually declined, reaching a low in the 1980s. However, the incidence of whooping cough has increased steadily since the 1980s, primarily among children too young to complete the full course of vaccinations.

Whooping cough is also on the rise among teenagers and adults, principally because immunity from the vaccine lasts for about five years and tends to decrease with age. With proper care, however, most teenagers and adults recover from whooping cough without complications. The disease is much more serious in children, especially infants younger than 6 months of age.

Why am I writing about whooping cough? There is a general lack of awareness in the general and medical community that this disease is back in full force. The number of reported

cases of pertussis continues to rise at a rate of great concern to the public health authorities. The US Centers for Disease Control and Prevention (CDC) has received 19,000 case reports for 2004, a nearly 40 percent increase over 2003, and the highest number in four decades. Various studies indicate that the actual number of pertussis cases is many times greater than what is reported.

The FDA Advisory Committee recommends booster pertussis vaccine for adolescents. It turns out that immunity after both vaccination and natural disease state wears off after 5-10 years. This leaves adolescents susceptible to pertussis, since currently, the last immunization is given before 7 years of age. Because pertussis is highly contagious, adolescents become a huge reservoir of this disease, increasing risk to all family members. The risk is most severe for children younger than 1 year, as the first two doses of pertussis immunization do not confer immunity.

Adolescents and adults may not have a cough with the whooping noise, and in between coughing spells patients may feel fine. Indeed, this is the hallmark of pertussis: a cold that progresses into paroxysmal coughing, which worsens at night and is nonproductive, while the patient feels otherwise well.

Adolescents and adults fare better than small children, but can still end up with pneumonia and/or broken ribs. The whole process can last for months. Treatment, which decreases duration of illness and spread of pertussis if diagnosed early, is usually 14 days of erythromycin.

After realizing the resurgence and consequent impact of this disease, it comes as no surprise that the FDA & CDC Advisory Panels have recommended unanimously that booster vaccines be given to adolescents. Boostrix, manufactured by GlaxoSmithKline is indicated for 10-18 year olds and Adacel made by Sanofiis indicated for use in 11- 64 year olds. These vaccines contain combinations for diphtheria, tetanus and pertussis. Talk with your physician or the Public Health Department.

I can't imagine a cough lasting a 100 days to a year…see your doctor, don't let a cough drag on and on! For more information you can Google pertussis or whooping cough.

Claudia Parks, RN is a former doctor's office and emergency room nurse and retired as an educator from Fulton County Schools. She writes Your Health Matters as a public service; the information here is designed to help you make informed choices about your health. It is not intended as a substitute for the advice of your physician. Claudia and her husband make their home in the beautiful north Georgia Mountains. Claudia can be reached at yhm@windstream.net.