University of Rochester

Currents--University of Rochester newspaper

Vaccine answers rise in whooping cough

Physicians may soon have a new weapon to combat the growing threat posed by rising rates of whooping cough. The results of a national vaccine study led by Michael Pichichero, professor of microbiology, immunology, pediatrics, and medicine, has shown that an experimental vaccine is safe and effective in teens and adults, carriers of the contagious respiratory disease that's dangerous to unvaccinated infants. The study is scheduled to be published in the June 22/29 issue of the Journal of the American Medical Association.

While the whooping cough, or pertussis, is less severe with age and often mistaken for bronchitis, teens and adults serve as reservoirs for infection in infants who are too young to be immunized. In addition, the complications of pertussis in some adults can include pneumonia, rib fractures, and seizures. In 2004, nearly 19,000 new cases--mostly adult--of pertussis were reported to the Centers for Disease Control and Prevention, up from 12,000 in 2003. Due to large-scale misdiagnosis, some experts believe that between 1 and 2 million U.S. adults and adolescents may now become infected annually.

While vaccination programs in children have reduced the threat, the infection rate is climbing rapidly among teens and adults, who, until recently, have been unable to receive pediatric whooping cough vaccines due to safety concerns.

"The arrival of a new combination vaccine for diphtheria, tetanus, and pertussis represents a major advance," says Pichichero. "Widespread use of the new acellular vaccines has the potential to counter a quadrupling of the pertussis infection rate in teens and adults in the last three years."

The experimental vaccine is under review by the U.S. Food and Drug Administration. If approved, it would become the second of two pertussis booster vaccines to become available this year. On June 29, the Advisory Committee on Immunization Practices of the Centers for Disease Control is scheduled to meet on the issue of whether or not to recommend that one or both of the new vaccines be combined with routine booster shots for tetanus and diphtheria as part of mass immunization programs.

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