Dr. Guiteras wrote a medical advice column for the Chapel Hill Herald from 1980 to 2000. He is now reviving the column for the CHFM website. The opinions expressed herein are those of the author, not necessarily those of the management of CHFM; even so, you can trust what you read here. If you have a question that you would like to have considered for this monthly column, send it to questions@chapelhillfamilymedicine.com. We will consider it for reply and reserve the right to edit the question to suit our needs. Please do not use this email address for any other purpose. Question: I have heard that whooping cough has become a threat again and that adults should be immunized. What’s the story? Should I take this shot? A NEW THREE POINT SHOT FOR ADULTS: TAKE IT. Whooping cough is back. It was a dreaded scourge in the first half of the 20th century and for centuries before that when there was no vaccine and no specific antibiotic treatment. Infants and children were especially susceptible and succumbed to its depredations in frighteningly high proportion. Adults were not free from attack but the effects were usually less severe. After introduction of a vaccine for whooping cough, also known as pertussis, incidence of this disease dropped more than 90%. All of us recall being hauled into the local health clinic or doctor’s office back in the ‘40’s and ‘50’s for our DPT shot and the even worse ordeal of watching our babies kick and scream as they got theirs a generation later. But it was well worth it: by 1976, the number of new cases in the United States dropped to its all-time low of 1,010. But in 2004, we had 25,827 cases. What happened? Why a 25-fold increase in 27 years? There are several known reasons and probably some we don’t know about. One important cause would almost surely be that immunity from childhood vaccination peters out after seven to ten years. Of cases reported between 2001 and 2003, 55% were in patients above age 10. So, in 2003, we got a vaccine that was safe for kids 11 to 18; this vaccine is called Tdap. It confers immunity to tetanus, diphtheria and pertussis. Then, in 2005, the FDA licensed a Tdap known as ADACEL for persons from 11 to 64. In late October 2005, the CDC’s Advisory Committee recommended Tdap for adults, to replace the standard Td we’ve been getting every 10 years. What? You say you haven’t had a Td since third grade? Well, now is your chance to get the new, improved three pointer, protecting you against the dreaded lockjaw, diphtheria and whooping cough. Take the shot! TOP Chapel Hill Family Medicine, PA · 120 Conner Drive · Suite 200 · Chapel Hill, NC 27514 Phone 919-967-8291 · Fax 919-967-3627