Saturday, September 22, 2018

Health

Illness making a comeback

Changes in vaccine and waning immunity likely are contributing to the resurgence of whooping cough, according to medical experts

  • LIFE-HEALTH-WHOOPING-COUGH-AT

    Last month Desmond Sewell, 12, receives vaccinations, including for Tdap — tetanus, diphtheria and pertussis, or whooping cough, from medical assistant Jessica Reyes at the Lou Colen Children’s Health and Wellness Center in Los Angeles.

    Tribune News Service

After a week with a dry cough, 16-year-old Ian McCracken started experiencing middle-of-the-night coughing fits so severe, he couldn’t talk. He returned home from his first trip to the urgent care clinic in mid-July with an inhaler and a five-day course of steroids.

The coughing fits didn’t abate, and after a few days, Ian jumped out of bed and got his mom’s attention by clapping his hands, unable to get any words out. The Decatur, Ga., teenager gasped for air, tears running down his face.

His mother, Karen Andes, took her son to another doctor, who suggested Ian may have reflux.

But a combination of Andes’ medical background (she’s an assistant professor of global health at the Rollins School of Public Health at Emory University) and a mother’s intuition told her something else was tormenting her son — pertussis, also known as whooping cough.

Whooping cough, a potentially life-threatening childhood illness, all but disappeared in the 1940s after a vaccine was developed. But in recent decades, the illness has been making a comeback. Changes in the vaccine and waning immunity are likely contributing to the resurgence of the illness, according to experts.

In recent years, there have been outbreaks not seen since the 1950s.

In 2012, the United States had the highest number of whooping cough cases in more than 50 years with 48,277 reported cases and 20 deaths. Most of the deaths occurred among infants, according to the U.S. Centers for Disease Control and Prevention. In Georgia, there were 318 cases in 2012, which included no deaths. Since then, there have been three whooping cough-related deaths (two in 2013 and one in 2016) in Georgia, and all of the deaths involved babies.

Last year, there was a total of 163 reported cases of whooping cough in Georgia, according to the CDC. And this year through Aug. 21, there have been a total of 102 cases, according to the Georgia Department of Public Health.

The highly contagious respiratory illness is not always on the radar of doctors and can be mistaken for a cold, bronchitis, reflux. The Georgia Department of Health said it’s not uncommon for someone to see two, even three doctors before getting a proper diagnosis.

Andes insisted on getting her son tested for whooping cough. Results from a nose culture came back positive.

“At first, I felt relieved, and even a bit proud of myself,” said Andes, “but then the reality sunk in that we may be in for more difficult nights.”

The older vaccine for whooping cough was phased out in the late 1990s. It carried a high risk of serious but temporary side effects like pain and swelling at the site of injection, as well as serious complications such as febrile convulsions, which are fits or seizures caused by a sudden change in a child’s body temperature, and loss of consciousness. One study by researchers at Kaiser Permanente’s Vaccine Study Center in Oakland, Calif., found the newer pertussis vaccine, while safer and with fewer side effects than the older version, is not as effective.

The 2016 study from Kaiser Permanente’s Vaccine Study Center found that the booster vaccine known as Tdap provides moderate protection against whooping cough during the first year after vaccination, but its effectiveness wanes to less than 9 percent after four years among teenagers who have received only a newer form of the whooping cough vaccine (known as acellular pertussis vaccine) as infants and children.

Tribune News Service


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