HEALTHPertussis a growing grown-up problemPhysicians are seeing more adult cases, and public health officials are calling for a higher index of suspicion.By Victoria Stagg Elliott, amednews staff. June 13, 2005. When Perri Klass, MD, associate professor of pediatrics at Boston University School of Medicine, became congested and couldn't stop coughing, she figured she had her annual case of "pediatric crud" -- an occupational hazard of seeing sick kids all day in the middle of winter. After a couple weeks when she still couldn't stop coughing, she started thinking about the possibility of pertussis. "It was the worst cough I'd ever had, and it wasn't going away," she said. Her internist assured her that pertussis was highly unlikely and suggested that the cough was the result of a lingering viral illness. Her doctor took a sample anyway, and sent it off to the lab. As it turned out, pertussis was exactly what she had. Thus, Dr. Klass became one of the growing number of physicians -- and adult patients -- who are learning that this illness can hit those older than 18 and is doing so with more frequency, primarily because of waning vaccine immunity. "It's harder to recognize in adults, but doctors need to think of it and think of it earlier rather than later," said Dr. Klass, who wrote about her experience in the May 13, 2004 New England Journal of Medicine. The number of pertussis cases has nearly doubled in the past decade, according to the Centers for Disease Control and Prevention. And, whereas adults used to comprise only a tenth of the total, they now make up more than a quarter. The uptick has led more physicians and public health officials to make presentations at medical meetings and publish papers to raise suspicion that an adult's chronic cough may be more. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2005 American Medical Association. All rights reserved.
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