Booster shots for whooping cough may be on horizon

Tuesday, July 13, 2004

Whooping cough, one of those ancient scourges that infant vaccination was meant to wipe out, is making a dangerous comeback: It turns out the vaccine that babies get starts wearing off by adolescence.

With outbreaks striking teenagers and adults, the government soon will decide if it's time for booster shots against the cough so violent it can break a rib. Last week, manufacturer GlaxoSmithKline sought Food and Drug Administration permission to sell a booster; competitor Aventis Pasteur isn't far behind.

While boosters are debated, however, don't lose sight of the real risk: Whooping cough can kill newborns before they start getting their vaccinations. And while older patients usually recover, they can easily spread the disease, known medically as pertussis, to infants.

"Parents who have very young infants need to get them vaccinated as early as possible," advises Dr. Trudy Murphy of the Centers for Disease Control and Prevention in Atlanta. Anyone who's coughing should "avoid contact with young infants on the chance this maybe is unrecognized pertussis."

Pertussis is a bacterial infection. Initial coldlike symptoms lead to fits of 15 to 20 coughs in a row that leave patients gasping for air -- often, but not always, with a high-pitched "whoop."

The incidence of pertussis plummeted in industrialized nations after vaccination began in the 1940s. It now is on the rise again globally.

Why isn't clear, but it's thought to be at least partly due to waning immunity.

In the United States, a preliminary CDC count found more than 11,000 pertussis cases last year. That's up from 9,771 the previous year, and the most recorded in three decades.

Several cases in Missouri

There have been no cases identified in Cape Girardeau County this year, but Cape Girardeau County Public Health Center director Charlotte Craig said there have been several cases in Ste. Genevieve, Boone, Osage and Cole counties.

"It's around us," Craig said.

According to Craig, Cape Girardeau County averages one or two cases a year, always involving younger children.

Glaxo last week asked the FDA to approve its Boostrix version for teens. The idea: People are supposed to get boosters against two other diseases, tetanus and diphtheria, every decade, including one for 11- to 18-year-olds. Boostrix simply adds a pertussis booster to the scheduled adolescent shot.

Competitor Aventis Pasteur wants to target adults, too. It is preparing to seek FDA approval to sell its Adacel pertussis-tetanus-diphtheria booster to ages 11 through 64.

The FDA is expected to make its decision on boosters early next year.

Staff writer Kathryn Alfisi contributed to this report.

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