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 offamiliar 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 to pneumonia.
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.
Society for Adolescent Medicine Takes Action
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 www.adolescenthealth.org/whoopingcough.html.
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 Zachary 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, Zachary 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, Zachary missed most of his ski season and could not adequately prepare for midterm examinations. In fact, Zachary experienced lingering symptoms of whooping cough through early April of this year, five months after the initial diagnosis.
"It took weeks to diagnose my son's condition since his symptoms mirrored those of a common cold," said Zachary'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 appear symptom-free.
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 immunized.
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.
About the Society for Adolescent Medicine
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 www.adolescenthealth.org.
About the Survey
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.