- The Washington Times - Wednesday, September 4, 2002

RICHMOND (AP) Virginia health officials are seeing more cases of severe whooping cough in infants as the highly contagious bacterial infection makes a national resurgence.
Twenty children in Virginia this year have been hospitalized with pertussis, said Jim Farrell, director of the division of immunization at the Virginia Department of Health. Another four hospitalizations are expected to be added to that number when pending cases are confirmed.
Last year around this time, 10 children had been hospitalized for pertussis, also called whooping cough because of the distinctive high-pitched whoop at the end of the cough. In all of last year, there were 19 pertussis hospitalizations in Virginia.
"We are getting more disease in young infants," Dr. Farrell said.
Pertussis is usually mild in adults, but babies who are unprotected or underprotected because they have not had their first or first few pertussis shots may get sick, sometimes critically so.
Babies get their first pertussis shot when they are 2 months old and usually are not fully protected until they have their fourth pertussis shot between 12 and 18 months. They are more likely to have a hard time if infected because their respiratory systems are immature. The bacteria are spread by airborne droplets.
In infants, the coughing can be profound.
"Sometimes they turn blue when they cough," said Dr. William Koch, an associate professor of pediatrics at Virginia Commonwealth University. "They have trouble feeding. They may be breathing so fast and coughing so hard they cannot take in enough nutrition."
In extreme cases, infants can develop life-threatening seizures, pneumonia and malnutrition, experts say.
There have been no pertussis deaths in the state this year or last, Dr. Farrell said.
A pertussis booster shot given between the ages of 4 and 6 provides children with additional protection. However, the vaccine's effectiveness gradually wanes so that by middle-school age, children are no longer protected. There is no adult pertussis vaccine approved for use in the United States.
"It's significant when you start to see more hospitalizations in infants," said Dr. Koch.
Federal experts say outbreaks seem to happen every three or so years, but they note that the overall case count has been rising since the 1990s.
Before a vaccine was developed in the 1940s, as many as 200,000 cases were reported annually in the United States. The vaccine reduced that to fewer than 5,000 to 7,000 cases a year, according to the federal Centers for Disease Control and Prevention in Atlanta.


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