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University of Cincinnati Academic Health Center
Publish Date: 11/30/99
Media Contact: AHC Public Relations, (513) 558-4553
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Common Cold or Whooping Cough?

CincinnatióMost people already know that whooping cough is a serious disease that can be prevented with a series of regular childhood vaccinations. But many are unaware that even though they were vaccinated as a child they can still become infected with the pertussis bacteria as an adult. Worst yet, whooping cough can be carried by adults and spread to infants because the vaccine does not provide a lifetime of immunity.

Alison Weiss, PhD, a University of Cincinnati (UC) Medical Center associate professor of microbiology, has studied the pertussis bacterium, Bordetella pertussis, for 20 years. She and Beverly Connelly, MD, associate professor of pediatrics/infectious diseases (ID) at the UC College of Medicine and the director of the Pediatric ID fellowship program at the Cincinnati Children's Hospital Medical Center, are working on trying to improve the effectiveness of the new vaccine introduced six years ago. "The current vaccine has fewer side effects than its predecessor, but it only provides immunity from whooping cough for a time," says Weiss. "Genetics and new techniques in molecular biology and immunology have enhanced research by allowing scientists to see things that they couldn't see five or ten years ago, but there is still no known way to test for pertussis immunity. Some people have a stronger immunity to the disease than others, and we are trying to find out why."

Connelly and Weiss are also recruiting children between the ages of six months and five years for a study in the effectiveness of the current vaccine. The new DTP (diphtheria, tetanus, and pertussis) vaccine is given to children at two, four, and six months and given as a booster at 12 to 18 months and at five years of age. Instead of containing the entire killed bacterium, it contains only isolated parts.

While Weiss believes the new vaccine is good, it does have problems. "One of the problems with the new vaccine is that researchers are still dissecting out what parts of the Bordetella pertussis are infectious," says Weiss. However, the new vaccine has less side effects than the whole bacteria, which caused high fevers and swelling at the injection site.

Pertussis is not just a disease of infants; older children and adults can become infected also. Treatment with erythromycin helps prevent the spread of pertussis, which can be a life-threatening illness for infants. Left untreated, an older brother, sister, or parent may serve as a reservoir of bacteria that can give a young child or infant whooping cough. Small babies cannot clear the bacteria out of their bodies very well and the toxin-induced secretions can suffocate them.

So when should parents worry? Pertussis patients rarely have high fevers. "A persistent cough without fever is what I worry about," says Connelly. Whooping cough begins like a cold. But if the coughing lasts more than two weeks or is so strong that it causes the patient to choke or even lose his dinner, there is a chance that it is pertussis.

Connelly's advice to parents who want to protect young children from whooping cough: "Make sure that the children receive their vaccinations on schedule, and keep them at least three feet or an arms length away from anyone with a coughing illness." The pertussis bacteria is transmitted in droplets and can be spread through direct contact or through the air.



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