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Pertussis: Vaccines
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Pertussis, commonly known as whooping cough, is a respiratory tract infection characterized by a paroxysmal cough. It was first identified in the 16th century. In 1906, Bordet isolated the most common causative organism, Bordetella pertussis. Bordetella parapertussis has ... been associated with whooping cough in humans. Before the advent of vaccinations, pertussis was a major cause of morbidity and mortality among infants and children. Reported cases of pertussis decreased by more than 99% after the introduction of pertussis vaccine combined with diphtheria and tetanus toxoids in the 1940s.
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Pertussis is the only infectious disease for which children are routinely immunized that is on the rise. In 1976, a record low of 1,010 cases were reported compared to 25,000 by 2004. Often misdiagnosed as a cold, pertussis may be vastly underreported. In 2004, more than 25,000 cases were reported, but the number of annual cases may be nearly one million. To be fully protected against pertussis, every child needs to get five doses of the DTaP vaccine by age seven. Pertussis is spread through droplets from the mouth and nose when an infected person coughs, sneezes or talks.
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Pertussis occurs throughout the world in all age groups. In the early twentieth century, it was a common childhood disease and a leading cause of infant death. Since the widespread use of a vaccine* starting in the mid-1940s... infection rates in children in the United States have declined. Teens and adults account for the majority of infections in the twenty-first century, which may indicate that childhood immunization with the vaccine does not offer lifelong immunity*.
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Pertussis reached epidemic levels in Maryland in 1993 and 1996. These increases in pertussis incidence in Maryland coincide with national increases. With regard to U.S. cases in 1993, the CDC reports that, "of 1,347 cases of pertussis among children seven months to four years of age with known vaccination status, 630 (46.8%) had received fewer than three doses of DTP vaccine-the minimum number of doses necessary for clinical protection." Reasons for the U.S. increase in 1996 are not clear, but may be a reflection of the 3-5 year cyclicity observed with pertussis. In Maryland outbreaks in Howard and Frederick counties and improved surveillance and reporting accounted for some of the increase. Incidence during the ten year period appears to have been strongly associated with age, with the highest incidence in children under seven months of age. Most of the cases among infants less than three months of age, and among adults received no pertussis vaccinations.
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The vaccine against Pertussis is included in the DTaP vaccine. Before age 7 children should get 5 doses of the this vaccine. These are usually given at 2, 4, 6, and 15-18 months* of age and 4 - 6 years of age. (*The 4th dose may be given as early as 12 months of age. A 6th vaccination is now being required at age 12 and is the combination vaccine Tdap.
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Pertussis vaccine is included in childhood DTaP vaccines against diphtheria, tetanus and pertussis. To be fully protected against pertussis, every child needs five doses of the DTaP vaccine by age seven. It is important to follow the recommended schedule because children are vulnerable to infection until they are fully vaccinated.
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