LYCOS RETRIEVER 
Pertussis: United States
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Pertussis is an endemic illness. In the United States epidemics occur every 3-5 years. The most recent epidemic occurred in 1996. Overall increase in cases since 1990, with disproportionate increase in adolescents and adults.
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The medical management of pertussis cases is primarily supportive, although antibiotics are of some value. Erythromycin is the drug of choice. This therapy eradicates the organism from secretions, there- by decreasing communicability and, if initiated early, may modify the course of the illness. Erythromycin or trimethoprim-sulfamethoxazole prophylaxis should be administered for 14 days to all household and other close contacts of persons with pertussis, regardless of age and vaccination status. Although data from controlled clinical trials are lacking, prophylaxis of all household members and other close contacts may prevent or minimize transmission. All close contacts <7 years of age who have not completed the four-dose primary series should complete the series with the minimal intervals.
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In the early 1940s, before the vaccine was available, about 200,000 people in the United States got pertussis each year. As you might imagine, after people started getting vaccinated, fewer people got sick. Since then... the number of teenagers and adults getting pertussis has increased. This is most likely because the vaccine from childhood wears off over time.
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CHICAGO - The American Academy of Pediatrics (AAP) has released a new policy statement recommending universal vaccination of adolescents at the 11-12 year-age visit, as well as catch-up vaccination of older adolescents, to boost protection against pertussis (whooping cough). The tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) - will replace the Td (tetanus and reduced diphtheria toxoids) vaccine in the childhood immunization schedule. The Td vaccine is used for booster doses for adolescents and adults.
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Before the introduction of the vaccine, more than 200,000 cases of pertussis were diagnosed each year in the United States. Since the 1980s, the U.S. Centers for Disease Control and Prevention (CDC) has reported yearly U.S. averages ranging from about 3,000 to 8,000 cases. In many developing countries in Asia, Africa, and Latin America... pertussis is still a major cause of childhood deaths; the CDC attributes 300,000 deaths worldwide every year to the disease.
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The number of reported cases of pertussis has been rising across the United States, heightening concern in the public health and medical communities. This is partly because pertussis immunity from early childhood vaccinations eventually wears off, leaving adults and adolescents susceptible to the disease. The most current data from the United States Centers for Disease Control and Prevention (CDC) indicate that the number of pertussis cases increased between the 1980s and 2005.(4) While the number of cases increased in all age groups, reports of pertussis have increased most dramatically among adolescents and adults. Most adolescents and adults are not diagnosed with pertussis because they frequently have milder disease.
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