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Whooping cough can produce symptoms that are severe and prolonged

Despite childhood immunization levels that are at an all-time high, the numbers of reported cases, hospitalizations, and deaths due to whooping cough have been steadily increasing. Whooping cough (pertussis) is a respiratory illness that leads to coughing severe enough to bruise ribs and, in extreme cases, to seizures or convulsions.

Since the 1980s, the reported incidence of whooping cough has been on the rise among adolescents and adults as the immunity conferred by childhood vaccines has worn off. As a result, whooping cough is responsible for substantial illness and increased costs among adolescents and adults, according to a study that was supported in part by the Agency for Healthcare Research and Quality (T32 HS00063).

From 1998 through 2000, medical costs for whooping cough for 1,679 adolescents and 936 adults were a mean of $242 and $326, respectively. A total of 83 percent of adolescents missed a mean of 5.5 days from school, and 61 percent of adults missed a mean of nearly 10 days of work because of pertussis. Also, 38 percent of adolescents and 61 percent of adults were still coughing when they were interviewed an average of 106 days and 94 days, respectively, after cough onset.

The societal costs and morbidity of pertussis in these groups need to be weighed against a booster vaccine's cost, efficacy, and frequency of adverse events, concludes Harvard medical school researcher Grace M. Lee, M.D., M.P.H. Dr. Lee and her colleagues identified pertussis victims through the Massachusetts enhanced pertussis surveillance system. They used State data to evaluate medical costs in these patients from 1998 through 2000, and interviewed the patients to determine nonmedical costs.

More details are in "Societal costs and morbidity of pertussis in adolescents and adults," by Dr. Lee, Susan Lett, M.D., Stephanie Schauer, Ph.D., and others, in the December 1, 2004, Clinical Infectious Diseases 39, pp. 1572-1580.

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