Call for Pertussis Vaccination for Healthcare Workers Endorsed by National Foundation for Infectious Diseases

BETHESDA, Md. -- The National Foundation for Infectious Diseases (NFID) supports new recommendations by the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) that healthcare workers and anyone who works in a healthcare setting should be protected against pertussis, also known as whooping cough.

The recommendations call for the tetanus-diphtheria-acellular pertussis (Tdap) booster to be routinely given to healthcare workers in place of the previously recommended tetanus diphtheria (Td) booster.  This development is in addition to the 2005 ACIP vote to recommend pertussis immunization for both adolescents and adults.

"Healthcare workers need to be protected against pertussis not only for their own health, but for the health of those in their care," says Susan J. Rehm, MD, NFID's medical director and an infectious disease specialist at the Cleveland Clinic.  "We hope these recommendations will be adopted quickly by the healthcare community to help reverse the growing number of cases across all age groups."

Protection from childhood pertussis immunization is now known to wane starting in adolescence.  In the U.S., there are approximately 8 million to 10 million healthcare workers employed in hospital and ambulatory settings; these workers are at risk of contracting and transmitting pertussis due to occupational exposure.

Some data from published studies on pertussis and healthcare workers report:

* The risk of contracting pertussis among healthcare workers is nearly two times greater than that among the general adult population.

* For each decade, immunization of healthcare workers could prevent as many as 100,000 cases of pertussis and save up to $151 million in costs (direct and indirect).

Pertussis is a highly contagious respiratory infection characterized by a prolonged, dry cough sometimes associated with a signature "whoop" sound.  While final 2005 estimates are not yet available, CDC data indicate that there were nearly 26,000 cases of pertussis in 2004, the highest number of case reports in four decades.  Pertussis is caused by bacteria found in the mouth, nose and throat.

Adults with pertussis may experience symptoms such as prolonged coughing, which is sometimes so severe that it causes vomiting, broken ribs and pneumonia, and may require hospitalization.  The illness, referred to by the Chinese as the "cough of 100 days," can take months to resolve and causes adults to have fitful sleep and miss work days.  In addition, adults may spread pertussis to others within close contact.  While the severity of pertussis symptoms varies in adults, it can be a life-threatening illness for infants who are not fully immunized.

The Food and Drug Administration approved two vaccines in 2005 that offer protection against pertussis to adults and adolescents and that also protect against tetanus and diphtheria.  One preparation can be used for both adolescents and adults, and the other has been approved only for use in adolescents.

In response to concern about the rising number of pertussis cases, NFID seeks to increase awareness among the public and healthcare providers about the disease and the importance of preventive vaccination across age groups.

Source: National Foundation for Infectious Diseases