North Carolina is seeing an increase in the number of pertussis (whooping cough) cases each year. Whooping cough is a highly contagious and vaccine-preventable disease that can be passed easily from person to person. This increase is not unique to North Carolina. The number of whooping cough cases in all age groups is rising across the country at a rate of great concern to the medical and public health communities.

In 1976, a record low of 1,010 cases were reported nationally. In 2004 and 2005 more than 25,000 cases were reported. Reported numbers, however, do not necessarily provide an accurate picture. In actuality, the number of annual cases may be close to one million. In North Carolina, 127 confirmed cases of pertussis were reported in 2005. This number jumped to 326 confirmed cases of pertussis in 2007.

Most children are protected against pertussis because of the DTP and DTaP (diphtheria, tetanus and pertussis) vaccines. However, immunity to whooping cough typically wanes 5 to 10 years after the last childhood vaccination. It is very serious for infants and can cause them to cough so much they cannot breathe. Whooping cough can cause adults or teens to have severe coughing that leads to vomiting or broken ribs. They can be hospitalized for pneumonia and miss weeks of work or school. Even worse, they can spread whooping cough to infants, who can suffer from severe complications or even death.

Tdap Vaccine

In the spring of 2005, two brands of a new vaccine to prevent tetanus, diphtheria and pertussis in teenagers and adults were licensed by the FDA and recommended for use by the Advisory Committee on Immunization Practices (ACIP). This new vaccine is called Tdap, and adds protection from pertussis to the traditional tetanus-diphtheria, or Td, booster.

Tdap vaccine is recommended for:

• Adolescents 11 through 18 years of age should get one booster dose of Tdap
  • A dose of Tdap is recommended for adolescents who got DTaP or DTP as children, but have not yet gotten a dose of Td. The preferred age is 11-12.
  • Adolescents who have already gotten a booster dose of Td are encouraged to get a dose of Tdap as well, for protection against pertussis. Waiting at least 5 years between Td and Tdap is encouraged, but not required.
  • Adolescents who did not get all of their scheduled doses of DTaP or DTP as children should complete the series using a combination of Td and Tdap.
• Adults 19 through 64 years of age should substitute Tdap for one booster dose of Td. Td should be used for later booster doses.
  • Adults who expect to have close contact with an infant younger than 12 months of age should get a dose of Tdap. Waiting at least two years since the last dose of Td is suggested, but not required.
  • Healthcare workers who have direct patient contact in hospitals or clinics should get a dose of Tdap. A two-year interval since the last Td is suggested, but not required.
  • New mothers who have never received a dose of Tdap should get a dose as soon as possible after delivery.

Additional Information on Whooping Cough and Tdap Vaccine:

• Frequently Asked Questions about Pertussis Disease
• Pertussis Information
• Tdap: What You Should Know
• Vaccine Information Statement for Tdap