Whooping cough is dangerous primarily in the first 6-8 months. The number of deaths for whopping cough has dropped dramatically, just like with other infectious diseases.
Due to this marked decrease whooping cough must not be reported since 1961, only cases of death must be reported.
In the USA, however, there has been an increase in the number of deaths as a result of whooping cough despite a high vaccination rate of 94% (WHO). This is probably due to the fact that the pathogen has been genetically modified. It can also be observed that there is a shift in the disease from adolescents to adults. The number of cases of whooping cough in adults between 1990 and 2001 rose by 400% according to the CDC. While only 1730 cases were reported in 1980 there were 8296 people who had contracted the disease in 2002.(MMWR Weekly January 10, 2003 / 52(01);1-4 ) The cause is the relatively fast drop in immunity after the vaccination compared to immunity after the disease has been contracted.
In total, 56-60 % of people who contract whooping cough have been vaccinated. (Impfen: Routine oder Individualisation Eine Standortbestimmung aus hausärztlicher Sicht, 2. Auflage 2000, Arbeitsgruppe für differnenzierte Impfungen, S. 21)
Children under 10 years of age the ones who contract whooping cough the most frequently. In populations that have a high vaccination rate approx. 50% of the reported case contract the disease in their first year of life, an additional 25% contract it before the turn 5 and 15% contract it as adolescents or adults (Lederle Praxis, 1995, Tetramune Swiss Safety Study in Supplementum XI,BAG). In industrial countries the WHO estimates that mortality is 0.04-0.5%(Ivanof B. WHO Global Program for Vaccines and Immunisations, International Symposium on Pertussis Vaccine Trials, Rome, October 29- November 1st, 1995)
The vaccination does not offer 100% protection as children who have been vaccinated can also contract whooping cough. The whooping cough vaccination is recommended for very young babies, the reason being that the whooping cough vaccination will prevent the babies from dying. But it should be known that most deaths due to whooping cough occur in the first 6 months. And only when the baby is 6 months of age is a sufficient immune response to be expected after application of available vaccines. However after the second vaccine dose the course of the disease can be expected to be not as severe (Impfen, Routine oder Individualisation, Arbeitsgruppe für differenzierte Impfungen2 Aufl. März 2000, S. 20)
The immunity as a result of the vaccination is much less than if it was naturally acquired. As a result of circumventing the mucous membrane during the vaccination the body does not produce sufficient antibodies on the mucous membrane (IgA).
Vaccination protection does not last long. 52% of children who have been immunized contract it in their second year of life, in the third year even 76% (Impfen, Routine oder Individualisation, Arbeitsgruppe für differenzierte Impfungen2 Aufl. März 2000, S. 20) However, the course the disease takes is more mild and there are fewer complications.
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