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Pertussis Case Increase Attributed to Need For Adult Booster Shots

February 21, 2011

WHEELING - The need for adult booster shots and a decline in childhood vaccination rates are two reasons why some diseases appear to be making a comeback, said Dr. William Mercer.

Mercer, Wheeling-Ohio County health officer, said not all childhood vaccines last a lifetime, resulting in adults needing a booster shot to strengthen their immunity to a particular disease. This may be why a number of pertussis cases have cropped up across the country, especially in California where in 2010 about 8,000 cases occurred and 10 infants died from the disease.

Last year, Ohio County had three cases of pertussis, also known as whooping cough, in children.

"We have a lot of cases in adults and they're the ones who pass it on but they don't get very sick," Mercer said. "It's the kids who get really sick, it's the infants."

Babies get vaccinated against pertussis in a series of shots. If they are exposed to the disease before becoming fully vaccinated, they can become sick.

"What we try to push is that adults get revaccinated with pertussis, especially if you have kids or are around kids," he said. "It's included in a regular tetanus. Everyone should get a tetanus shot every 10 years."

Fact Box

Why are diseases once believed eradicated making an appearance again? Is this something that will be more prevalent in the future?

While diseases such as tuberculosis were eradicated in the United States and Europe, in other Third-World countries the diseases never left. Health officials believe patients not taking their medicines and the indiscriminate use of antibiotics has led to diseases becoming more drug resistant.

The Adacel vaccine includes tetanus, pertussis and diptheria, Mercer noted.

"If you have a cough for more than two weeks, there's a 20 percent chance it's pertussis," he said.

Tuberculosis is another disease that appears to be making a comeback.

Mercer said while TB is under control in the United States, it has continued to flourish in Third World countries.

"A third of the (world's) population is infected with TB. People don't realize that," Mercer said, noting there are folks carrying the disease who don't know it because they are asymptomatic.

"Luckily it's low here in the United States, but in the Third World countries TB is a problem," Mercer said, noting poorer countries often do not have the means to treat their population infected with such a disease.

Mercer said a simple skin test can be used to detect whether someone is carrying TB, which is caused by the bacterium called Mycobacterium tuberculosis. He noted physicians are beginning to see some drug resistance to TB, which is a "very contagious disease."

This has occurred, he said, as a result of people infected with the disease not taking their medicine as directed.

"We still see it here," Mercer said of TB. "One of the things that has made a difference with TB is our (health department) staff makes sure (patients) take the medicine. They watch them swallow it. It's called direct observe therapy. It has made a difference."

The health department periodically holds TB diagnostic clinics. During the clinics, the TB clinic X-rays are used to evaluate whether the disease is active or latent. Clinicians are also there to diagnose and treat. And medications are available for TB cases and latent TB infection patients.

According to the Centers for Disease Control and Prevention, the general symptoms of active TB disease include: unexplained weight loss, loss of appetite, night sweats, fever, fatigue and chills. And the symptoms of TB of the lungs include coughing for three weeks or longer, hemoptysis (coughing up blood), and chest pain.

"TB is still a major player in the world," Mercer said.

Methicillin-resistant Staphylococcus aureus, also known as staph, also is making a resurgence because it is becoming resistant to antibiotics, he said.

"One of the problems we do see with infections is the indiscriminate use of antibiotics has caused some of these superbugs," Mercer said.

Physicians who willingly prescribe antibiotics when they are not called for is a contributing factor, he added. And, there are more antibiotics in the environment in general. For example, livestock are given antibiotics to keep them healthy. Trace amounts of antibiotics and other drugs also have been found in water.

Mercer noted the best way to keep diseases from resurging is for people to get vaccinated against them. There are several childhood vaccinations that youths must receive to stay healthy. Adults, however, should consult their doctor about receiving booster vaccinations, such as one for tetanus. There are also adult vaccines to ward off pneumonia and shingles.

According to the latest data, Mercer said, 26 percent of the deaths around the world in a given year are caused by infectious diseases.

In terms of childhood vaccines, West Virginia and Mississippi are the last two states that require children entering school to be vaccinated - and Mercer wants it to stay that way. Some parents are opting not to have their children vaccinated for religious reasons, while others believe vaccines are connected to autism - despite research stating otherwise, he noted.

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