Whooping cough a concern again; seventh graders required to get booster shot before school

Whooping cough appears to be on the decline in Maryland after spiking to record levels two years ago, bucking a nationwide trend that has public health officials concerned about a resurgence of the illness.

Students entering seventh grade this year are still required to show proof that they’ve had a booster shot to prevent the disease, officially known as pertussis, said Greg Reed, program manager for immunizations for the Maryland Department of Health and Mental Hygiene.

“Whooping cough is becoming a concern again,” Reed said. “We hope with this new school requirement, we’ll see the number of cases go down.”

The highly contagious disease is called whooping cough because of the trademark whooping sound that some make when gasping for air after coughing.  

In Maryland, cases of whooping cough increased by two-thirds from 2011 to 2012 before dropping in 2013.

According to DHMH, there were 123 reported cases in 2011. The following year, there were 369. Last year, there were 213.

“The spike we saw was really part of a spike that was going on throughout the country,” Reed said. “It started in California, then it made its way east.”

 

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While 2014 numbers weren’t available from DHMH, Reed said he expects to see fewer whooping cough cases than last year.

 

“There’s no one reason why the numbers in 2013 are lower than they were in 2012,” Reed said. “2012 was probably an aberration, and it looks like we are going back down to our normal disease levels.”

Between 2007 and 2011, the number of annual cases of whooping cough hovered in the 130 range, Reed said.

But nationally, cases of whooping cough are still on the rise, said Alison Albert, a spokeswoman for the Centers for Disease Control and Prevention.

As of mid-June, cases had increased 24 percent over the same time last year, Albert said. And that trend is likely to continue, though whooping cough tends to be cyclical, increasing in some parts of the country while declining or remaining stable in others.

According to the CDC, there were more than 48,000 cases of whooping cough reported in the U.S. in 2012, the most in nearly 60 years. But that number had been on the rise for several decades. The American Lung Association estimates there were 12 times more cases of whooping cough in 2012 than there were in 1992.

Albert said the disease is often wrongly thought of as a “disease of the past.” Eight deaths from whooping cough have been reported to the CDC this year, and more than and 15,780 cases have been reported.

Albert said the main reason is because children began receiving a new type of whooping cough vaccine in the late 1990s, which was thought to be safer.

“The old vaccine was very effective, but it caused a lot of redness and swelling and side effects,” said Dr. Norman Edelman, senior consultant for medical affairs for the American Lung Association.  

The new vaccine is still effective, but it doesn’t last as long as researchers originally thought it would. It starts to wear off after about eight to 10 years, Edelman said.

Because the protection begins to decline after a number of years, doctors recommend children get the Tdap (tetanus-diphtheria-pertussis) booster shot by age 11 or 12.

Edelman said the anti-vaccine movement could be another reason for the increase in whooping cough cases. 

“I think if we have enough cases, parents will wise up and start vaccinating their kids,” he said. “These parents are relying on herd immunity, thinking if everyone else is vaccinated, they don’t need to vaccinate their child. And that’s not true.”

Adults who didn’t get a whooping cough booster shot as an adolescent are also encouraged to get the Tdap shot now, especially if you are pregnant or planning to be in close contact with a baby, Albert said.

About half of infants who are younger than a year old and contract whooping cough are hospitalized, according to the CDC.

Complications due to severe coughing can include cracked ribs, pneumonia and difficulty breathing, sleeping or eating, according to the American Lung Association.

In addition to the perception that it’s an old-time disease, there are plenty of other

myths about whooping cough.

Though the infection can last up to 10 weeks, some people don’t even know they have whooping cough, Albert said. Not everybody makes the whooping sound, she said.

Others also falsely believe adults can’t get whooping cough.

“Whooping cough never went away,” Albert said. “We’re not getting cases because people are bringing it over from other countries.”  

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