Adolescents and some adults should be revaccinated against pertussis, also known as “whopping cough,” to decrease the risk of transmission to infants, according to a report in Clinical Infectious Diseases.

Pertussis is very common, Dr. Kevin D. Forsyth from Flinders University, Adelaide, South Australia told AMN Health. “We need high awareness and a high index of suspicion of the disease; we want better and more standard diagnostics and clinical definitions, and we want to see immunization be more universally implemented, at least for adolescents and those around and caring for young children.”

Forsyth and members of the Global Pertussis Initiative analyzed pertussis disease trends and investigated alternatives to improve disease control through expanded vaccination strategies.

According to the findings, as many as 32 percent of adolescents and adults with a coughing illness lasting one to two weeks or longer have pertussis, but the largest risk is for infants, especially those not fully vaccinated.

Waning immunity underlies the risk of pertussis in older individuals vaccinated in childhood, the authors point out, suggesting that vaccination strategies should be reconsidered.

The researchers recommend a variety of region-specific approaches. For example, in North America vaccination of all adolescents and adults would foster lifelong immunity to pertussis infection.

In Europe, adding booster vaccinations for preschoolers and adolescents and selective vaccination of health care workers appears more appropriate. In Australia, Argentina, and Japan, vaccination of all adolescents could reduce illnesss in adolescents and young adults.

Nevertheless, Forsyth concluded that there are many unanswered questions and “we want to…see what happens as our recommendations are implemented in different countries.”

SOURCE: Clinical Infectious Diseases, December 15, 2004.