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Saturday, May 10, 2003

Whooping Cough Making Comeback

Associated Press


ALBUQUERQUE — State health officer Gary Simpson says it’s a chilling sound — a child with whooping cough.

But it’s a sound that’s being heard more often with the comeback of whooping cough — named for the characteristic whoop sufferers make as they take a breath.

“They’re struggling to get their breath in, their airways are always closed,” said Simpson, medical director of the Infectious Disease Bureau at the state Health Department. “Once you’ve heard it, you’ll never forget it.”

Sufferers have dramatic coughing spasms that cause severe shortness of breath and sometimes vomiting. The spasms are powerful enough to break ribs or give people hernias.

Cases are being seen not only in children, but also teens and young adults growing vulnerable as childhood vaccinations wear off. Inoculations for whooping cough, also known as pertussis, are good for about 12 years.

Teen and young adults carrying the disease pose a threat to those most at risk of dying from it — children under 2 and senior citizens, said Joan Baumbach, an infectious disease epidemiologist with the Health Department.

A 2-week-old girl who died in Albuquerque in January was the state’s first whooping cough death since 1998, when a 2-week-old died in McKinley County.

“We have a significant problem with pertussis in New Mexico. ... We worry a lot about infants contracting it, and older adults who may be debilitated with immune-compromised systems that have a hard time fighting the infection off,” Baumbach said. “We’ve been dreading for years that there would be another death, and this year there was.”

Childhood vaccinations, given at 2, 4, 6 and 12 months, wear off by the time a child turns 13. No booster shot yet exists.

Health Department figures show New Mexico had 18 reported cases of pertussis, or 1.2 per 100,000 people, in 1990. In 2001, there were 137 cases, or 7.4 per 100,000. Last year, there were 200 cases, which aren’t yet tallied with population for a rate.

The national average has risen from about one in every 100,000 in the late 1980s to about three in every 100,000. Both the state and national figures are “probably an underestimate” because many doctors don’t report cases, Baumbach said.

Whooping cough is most contagious before the onset of symptoms. It’s spread by its primary symptom, the propulsive cough. Ninety percent of unvaccinated people who breathe it in become infected, the CDC said.

The disease lasts weeks or months. It can be treated with antibiotics in its early stages, but becomes harder to treat the longer it lingers.

New Mexico also has one of the worst records for completing childhood vaccinations.

Nationally, 81.5 percent of children finish the shots before reaching 19 months. New Mexico’s average is 70.7 percent, said Steven Nickell, state immunization program manager. The state average reaches about 95 percent, the national average, by the time those children start kindergarten, he said.

“The problem with pertussis is not that some are not vaccinated, but the ones that are vaccinated often haven’t completed the series, so they’re still vulnerable,” Nickell said.

People who believe they have pertussis should see a doctor to confirm it, Baumbach said.

“For those that think they might have it, one of the key things is a prolonged cough,” she said. “A lot of upper respiratory things can cause a cough that lasts two weeks, but these last longer and are much harder. ...

“People just don’t think it could be whooping cough. But it is, in fact, a very real problem.”

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