BLUE SPRINGS, Mo. -- With cold and flu season just around the corner, parents need to be aware of another serious illness that could affect their teenagers, pertussis. Commonly known as whooping cough, pertussis is a highly contagious bacterial infection of the respiratory system that causes spasms of severe coughing and often masquerades as common ailments such as a cold or the flu.
According to the Centers for Disease Control and Prevention (CDC), it is estimated that 39 percent of the reported pertussis
cases in 2003 affected children between the ages 10 and 19. Recent outbreaks
have prompted a growing concern in the public health community that parents
and teens are not aware of these trends and may assume this highly contagious
disease, which can be serious in infants, is just a cough.
According to the results of a new national survey of parents of teenagers
conducted by the Society for Adolescent Medicine (SAM), less than one in five
parents surveyed (approximately 18 percent) reported being concerned with the
prospect of their child contracting pertussis, and more than 25 percent aware
of the illness could not name one symptom. It is important for parents, teens
and healthcare providers to remember that childhood immunization against
pertussis wears off five to 10 years after the last routine vaccination shot
(administered when children are between four and six years old). According to
the survey, the majority (85 percent) of parents of adolescents did not know
the duration of pertussis protection. Today, many adolescents are vulnerable
and unprotected against this serious disease.
There have been numerous outbreaks over the last year in many states,
including New York, Illinois and Wisconsin where most of the patients were
adolescents. Afflicted teens are often forced to sit on the sidelines, unable
to attend classes, or participate in sports and social events for a week or
more because of the severity of their illness. In fact, pertussis sufferers
may experience more than two months of severe, uncontrollable coughing
episodes that can occur 15 times within 24 hours. These coughing fits can lead
to vomiting, a hernia, or even a broken rib. In some cases, pertussis can lead
Even when school is out of session, pertussis finds ways to sicken
teenagers, with recent outbreaks at summer sleep-away camps. Although
whooping cough is rarely fatal in older children, the mortality rate is
highest in unvaccinated infants who can catch the illness from adolescent
family members or babysitters.
These survey results and the recent surge in pertussis outbreaks prompted
SAM to launch an educational campaign for teens and their parents, called
"More Than Just a Cough." The campaign also encourages parents of teens to
schedule routine health visits.
"After the immunization series is completed by age six, pertussis
immunization is rarely discussed at healthcare visits. Few parents realize
that the protection from the pertussis immunization wears off after five to 10
years, leaving teens vulnerable to whooping cough," said Dr. Amy Middleman,
assistant professor of pediatrics, Adolescent Medicine Section, Baylor College
of Medicine. "Parents need to be made aware of pertussis symptoms. Because
adolescents often do not exhibit the classic 'whoop' that is associated with
the disease, symptoms such as a mild fever, severe coughing fits and runny
nose are often mistaken for flu or the common cold. However, anyone
experiencing these severe coughing fits for seven or more days should seek
diagnosis by a healthcare provider."
The CDC recommends that physicians test for pertussis if patients exhibit
symptoms compatible with the disease or develop an acute cough after exposure
to someone who has been diagnosed. If caught early enough, antibiotics may
help alleviate symptoms or limit the spread of the disease.
To help educate parents and teens about whooping cough, SAM is providing
free information about the signs and symptoms of whooping cough, as well as
the importance of routine adolescent health visits, available at
Zachary's Battle With Pertussis: One Teen's Story
Over the past year, there have been pertussis outbreaks across the country
that have significantly impacted the adolescent community. For example, 16-
year-old Zachary Graham, a competitive skier from New Hampshire, suffered a
bout of pertussis last winter. When Graham began coughing just before the
Thanksgiving holiday, his parents assumed it was a result of a winter cold.
As a competitive athlete and school leader, Graham tried to dismiss his
illness and traveled to Lake Placid for Olympic skiing training sessions.
Within a few days, however, his condition worsened with severe coughing fits,
vomiting and difficulty sleeping and breathing. As a result of his illness,
Graham missed most of his ski season and could not adequately prepare for
midterm examinations. In fact, Graham experienced lingering symptoms of
whooping cough through early April of this year, five months after the initial
"It took weeks to diagnose my son's condition since his symptoms mirrored
those of a common cold," said Graham's mother, Betty May Graham. "In fact,
it wasn't until a visit with a pulmonary specialist that he was finally
diagnosed with whooping cough. I was shocked when Zachary was diagnosed with
whooping cough because he had been vaccinated against the disease as an
infant. It was such an emotional time for us and Zachary and if people lived
that experience with us, they would understand that whooping cough is a
terrible illness," she added.
Pertussis can be difficult to detect because the first symptoms are
similar to the "common cold" with a mild fever, runny nose and a cough.
Symptoms generally progress to more severe coughing episodes, often with a
high-pitched "whoop," followed by vomiting. These severe coughing spells can
last for more than two months. A person experiencing these severe coughing
spells may become blue in the face, and infants may actually stop breathing
for a few seconds. Between coughing spells, it is typical for individuals to
It is important for parents to know that adolescents generally exhibit
different symptoms of the disease, often without the classic "whoop," making
it difficult to recognize. While pertussis is threatening to all, this highly
contagious disease can be serious in infants who are too young to be fully
Currently, pertussis vaccination is given in combination with diphtheria
and tetanus (DTaP) in five doses given at two, four and six months of age, 15
to 18 months of age and four to six years of age. However, immunity to
pertussis wears off five to 10 years after the last childhood dose leaving
many teens unprotected against the disease.
"Adding a pertussis component to the current tetanus-diphtheria booster
vaccine routinely administered to 11 and 12 year olds could help control
community outbreaks and protect older children and teens from this serious and
highly contagious disease. Such a vaccine is currently being reviewed by the
FDA, and may be available in 2005," Middleman said.
The Society for Adolescent Medicine founded in 1968, is the only
multidisciplinary professional healthcare organization in the United States
exclusively committed to improving the physical and psychological health and
well being of adolescents. Its principal activities include the development,
synthesis and dissemination of scientific and scholarly knowledge unique to
the health needs of adolescents; professional development of students,
trainees, and practicing clinicians around adolescent health; as well as
advocating on behalf of adolescents.
Advocacy efforts are supported through local, state and national public
and private efforts to develop comprehensive, acute, chronic and preventative
health services for youth. The Society publishes and disseminates scholarly
information related to adolescent health through its peer-reviewed monthly
Journal of Adolescent Health. For more information, log on to
Data was collected online between June 11, 2004 - June 17, 2004, with a
nationally representative sample of 1,622 parents (both mothers and fathers)
of adolescents. The survey was funded by GlaxoSmithKline.
Source: Society for Adolescent Medicine