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Article Excerpt
Deborah Dohne, 42, a college professor in Syracuse, N.Y., didn't think much of it when she developed a mild fever and sore throat in mid-May 2006. "I thought maybe I had a cold and kept going about my business," she says. But two weeks later, she wasn't getting any better. By the third week, she started vomiting and her throat became so swollen she could barely swallow.
She went to the emergency room where physicians suspected strep throat and performed a throat culture. The test came back negative, but they said there was still a chance she could have strep throat and they gave her an antibiotic.
Four weeks into her illness, Dohne felt even worse. She developed a loss of appetite, sinus congestion, chest tightness, fatigue, and a relentless cough. "I took cough medicines, but nothing helped," she says. "When I talked or laughed, it made me cough even more." Doctors suggested that her symptoms could be caused by an infectious disease, such as mononucleosis, or allergies.
After the cough persisted for three more weeks, Dohne's primary care physician performed a blood test to check for whooping cough (pertussis). That test came back positive, and Dohne began seeing an infectious disease specialist. "I had never even heard of pertussis," Dohne says. "I had heard the term 'whooping cough,' but I didn't think anybody got that anymore." Dohne had received a vaccination against whooping cough as a child.
Whooping cough is a bacterial respiratory illness characterized by severe spasms of coughing that can last for weeks or even months. In September 2006, Dohne experienced soft tissue damage in her back from coughing so hard. Severe coughing has also given her bloodshot eyes. "I've had dreams where I'm just coughing and coughing and coughing," she says. "It's a scary feeling--you feel like you'll be coughing forever."
Because of her illness, Dohne took an entire semester off from teaching. "In addition to the cough, fatigue has been an incapacitating problem," she says. Dohne suspects that she contracted whooping cough from a student who may have been ill, but she isn't sure. The disease is spread by close contact with respiratory tract droplets that are released when a person coughs or sneezes.
The introduction of a whooping cough vaccine in the 1940s led to a marked decline in cases and deaths from whooping cough in the United States. But as with other vaccine-preventable diseases, whooping cough still exists. That's why continued vaccination is so important. Vaccines help create antibodies, an important element in the body's defense against foreign substances.
According to the Centers for Disease Control and Prevention (CDC), rates of whooping cough have been on the rise in all age groups in the United States since the 1980s. In the pre-vaccine era, people were frequently exposed to the bacteria that cause whooping cough, providing periodic boosts to their immunity. But with the elimination of most of the natural infection, the chance of immune boosts lessened. As a result, many adolescents and adults were without antibodies to the infections. This situation was compounded by the absence of a vaccine against whooping cough that could be used in people ages 6 years and older.
In 2005, the Food and Drug Administration licensed two whooping cough vaccines for use in adolescents and adults that will allow these groups to have immunity again against the infection. Both vaccines are combination boosters that protect against tetanus, whooping cough, and another respiratory disease called diphtheria.
"Vaccines aren't only for young children," says Norman Baylor, Ph.D., director of the Office of Vaccine Research and Review in the FDA's Center for Biologics Evaluation and Research (CBER). "We want to get children off to a healthy start by giving them the recommended series of vaccinations, and adolescents and adults should also know that they need certain vaccinations to remain protected throughout their lifetime. Serious illness and deaths from many infectious diseases have declined because of vaccination. But if we stopped vaccinations, we would see disease epidemics again."
Here's a look at vaccines that have been recently licensed by the FDA, along with the latest recommendations from the CDC's Advisory Committee on Immunization Practices (ACIP) for young children, adolescents, and adults. The ACIP consists of 15 experts, as well as liaison members from other parts of government including the FDA, who advise the CDC's director and the Secretary of the U.S. Department of Health and Human Services on the control of vaccine-preventable diseases. The ACIP's key role is to make recommendations on immunization practices in the United States, including which FDA-licensed vaccines will be recommended for routine use in children in the United States. The ACIP provides practice of medicine recommendations based on different criteria from those which the FDA must use for vaccine approvals/licensure, so some recommendations on the CDC's Web site may differ from a vaccine's label.
For Young Children
By ages 4 years to 6 years, children should have received vaccinations that protect them from a string of diseases, including influenza, diphtheria, tetanus, whooping cough, chickenpox (varicella), hepatitis A and B, polio, pneumococcal diseases, measles, mumps, German measles (rubella), diseases due to Haemophilus influenzae, and rotavirus.
In September 2006, the CDC announced that immunization rates for children 19 months to 35 months of age remain at or near record highs. About 80 percent of 19-month to 35-month-old children...
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