If you think you shouldn't be worried about your child's lingering, nagging cough, think again. Pertussis - better known as whooping cough - has reemerged on the scene.

It's probably time to check that immunization record.

"As a parent, we should take every opportunity to get immunizations and get them in a timely fashion," says Dr. Lynnette Mazur, professor of pediatrics at The University of Texas Medical School at Houston. "First, get your child to a doctor for a proper diagnosis if she has a runny nose or cough that lasts more than a week."

The Rise of Whooping Cough

Pertussis is back, huh. Did it really ever go away?

Mazur says that although pertussis has always been with us, the highly contagious disease is spreading, mainly due to the pertussis vaccine's ability to fade over time.

"The vaccine has a limited time span and only lasts from six to10 years," Mazur adds.

"It cycles every few years and settles down. But it's always there."

Pertussis stems from invading bacteria in the nose, mouth and throat. It is spread through the air through coughing and sneezing. It mildly affects immunized school-aged children and adults, but it can pose a health hazard in infants less than 1 year old. Seizures, pneumonia - and in rare cases - brain damage and even death may occur. Up to 1 percent of children with pertussis die from the disease.

Sign of the Times

Pertussis signs show themselves from one to three weeks after infection. Mazur says symptoms can be hard to detect at first because pertussis mimics a cold. The constant coughing has little or no fever with it. Many whooping cough sufferers appear well.

The signature whooping cough can be a violent assault on the body, and no amount of cough syrup can make it go away.

What parents and patients need to know is that the cough itself can linger for months.

The Virtues of DTaP

The standard vaccine DTaP, a combination vaccine that protects against diphtheria, tetanus and pertussis remains the vaccine of choice. The Centers for Disease Control and Prevention (CDC) recommends that by age 7, children should have received DTaP shots at ages 2, 4, 6 and 18 months.

After age 7, is it a good idea to get another shot? Mazur says it could be.

"There used to be a reluctance to immunize a person older than age 7 because of the severe side effects of the first pertussis vaccine," Mazur explains. "With DTaP's new formulation, there are fewer bad reactions and we have a safer vaccine."

A Shot in the Dark

Mazur says it's possible that older children and adults should be encouraged to get vaccinated to protect against the spread of pertussis.

"We need to look at adults, who are a big reservoir for pertussis," Mazur adds. "Adults may need a shot every 10 years, but more research is needed to find an even better vaccine."

Researchers are looking at new ways to reduce the number of shots and come up with vaccine formulas specifically created for adults to reduce the spread of pertussis.

Getting a Handle on Pertussis

For a bacteria that seems like a cold, pertussis can steer you wrong. Don't self-diagnose. Get a check-up. That visit to the doctor's office could prevent that cough from getting out of hand.

"Pertussis can progress. Your best chance of treatment is an early start on the antibiotic erythromycin, which can shorten the course," Mazur says.

In the end, Mazur says immunize, immunize, immunize.

"The combination vaccine is the best way to prevent pertussis. And it requires fewer pokes. That's even more good news for our children."

UPDATED: 11-01-2004

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