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Tuesday, January 8, 2008

Whooping cough reminds me of whooping cranes which reminds me of the crane position that the Karate Kid does at the end of the movie...

Pertussis (aka whooping cough) has made a bit of a resurgence in the past several years, particularly amongst people in their 20's. I remember that my freshman RA got it and I avoided her like she had the plague.

It has been steadily increasing over the past several years and there are a couple of thoughts as to this. One thought is that the vaccine that is given in childhood for this (DTaP) loses its effectiveness once you enter your early teens and young adulthood. The other thought is that some batches of the vaccine may be improperly given or stored, thus resulting in an ineffective dose. Whatever the case, pertussis has increased from a little over 1,000 cases in the 1970s to over 25,000 in 2005 (check out this website for some interesting population maps).

So what's so bad about pertussis, anyway? If you are a school aged kid, teenager or adult, not too much more than a really annoying cough for, oh, a month or so. The ones who really get in trouble are the infants and toddlers who have not received any or only a partial series of vaccine. Most will do okay, but all it takes is seeing one kid on a vent because of it and you never want to see it again.

As a result, the AAP started recommending the TdaP vaccine for teenagers. It is basically a combo of the tetanus booster that you get when you go into high school PLUS a booster of the pertussis vaccine. A lot of OBs are also recommending it for mothers of new infants whose immunity may have waned.

On the touchy subject of vaccines, one of those funny bits of bloodwork that the OB screens for during pregnancy is your rubella titer (rubella+babies=badness). They haven't come up with a booster yet for the rubella virus, but I have heard of some family docs doing a rubella screen on adolescent girls to see if they are rubella immune and giving another dose of MMR if they aren't. Just a thought.

On that note, wax on, wax off.

*Image from pertussis.com

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