NEW YORK (Reuters Health) - Federal health officials are urging doctors to consider a diagnosis of whooping cough, or pertussis, in adults with a cough lasting two weeks or more.

"The number of pertussis cases in adults has risen substantially since the 1980s," according to researchers from the US Centers for Disease Control and Prevention (CDC). While all children routinely get a pertussis vaccine, US cases have increased from 1,730 in 1980 to 8,296 in 2002--the highest number of reported cases since 1967.

An individual infected with Bordetella pertussis, the bacteria that cause pertussis, can experience a "whooping" sound as they inhale after a coughing fit, and may cough so hard that they vomit or faint. However, adults can have mild symptoms and might spread the highly infectious bacteria to babies, who are at greatest risk. About 0.8% of babies under six months of age who are infected with pertussis die of the infection.

Adolescents and adults may become infected with the bacteria because vaccine protection can wane 5 to 15 years after the last dose, the researchers warn. As a result, the CDC says pertussis vaccination "might have a future role in the prevention of disease and control of outbreaks in older age groups."

Typically, doctors will treat the infected patient with antibiotics and give antibiotics to close contacts to prevent infection.

In the CDC's Morbidity and Mortality Weekly Report, officials report a recent outbreak of pertussis among workers at an oil refinery in Illinois. Seventeen workers were diagnosed with pertussis and an additional 7 patients with pertussis were identified in the community. All 24 and 150 of their close contacts were effectively treated with antibiotics. No new cases have been reported since October.

Of note, pertussis was not initially considered in the original patient, who had a cough for 14 days, until the patient's supervisor also developed similar symptoms.

SOURCE: Morbidity and Mortality Weekly Report 2003;52:1-4.

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