Mumps also increasing, but so far only in Europe :::::::::::::::::::::::::::::::::
While every parent worries about colds and the flu, some childhood illnesses are no longer a problem thanks to vaccinations, right? Wrong. Two diseases-mumps and pertussis-are making a comeback.
Pertussis cases are increasing in the United States, although none yet have been reported in Illinois this year; mumps cases are on the rise, but so far only across the sea in the British Isles.
The Centers for Disease Control and Prevention reports in 2002 there were 9,771 cases of pertussis-better known as whooping cough-nationwide, the highest since 1964. Dr. Trudy Murphy, an epidemiologist with the National Immunization Program, cites two reasons for the dramatic increase.
"People are doing a better job of recognizing it," she says. "The vaccine protection for pertussis wanes over time and the illness in the past was not well recognized." The two age groups most affected in 2002 were infants younger than 6 months (21 percent of cases) and children ages 10 to 19 (29 percent). Babies under 6 months are at risk because they have not received the first three doses of the diphtheria, tetanus and pertussis vaccine, also known as the DTaP. Complications of pertussis in infants and young children can include pneumonia, seizures and death, according to the CDC.
Children ages 10 to 19 are vulnerable, Murphy says, because "the vaccine begins to wear off in five to 10 years and it's not perfect. It's effective about 85 percent of the time." Although there is no pertussis vaccine licensed for use in adolescents, Murphy says "a couple manufacturers are developing them, and they should be available in the next couple of years."
Ohio, Indiana, Michigan and Wisconsin all have reported pertussis cases this year.
Parents who have a child with severe coughing and whooping, or who have those symptoms themselves, should see a doctor for antibiotics. Equally important, says Murphy, is to avoid contact with babies, since pertussis tends to be more severe in not-yet-vaccinated infants.
Mumps cases, characterized by painful, swollen glands in the neck, also are rebounding but not yet in the United States. The National Health Service for Scotland reported 259 cases in Scotland in 2002, up from 155 in 2001. In addition, the Health Protection Agency in the Great Britain reports 1,529 cases in England and Wales in 2003, over three times as many as in 2002. Most cases occurred in teens and young adults who were too old to receive the measles, mumps and rubella (MMR) vaccine when it was introduced in the U.K. in the late 1980s.
Parents in this country do not really need to worry, though. "Mumps for the most part has decreased here," says Dr. Susan Reef, a medical epidemiologist with the CDC. "There were fewer mumps cases than last year, and we have not seen a decrease in effectiveness of the vaccine."
The CDC recommends children receive five doses of the DTaP vaccine, at 2, 4 and 6 months as well as 15-18 months and 4-6 years. The agency also recommends children receive the first dose of the MMR vaccine at 12-15 months and the last between 4 and 6 years.
For more information about pertussis and the mumps, visit www.cdc.gov.
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