Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
What is the Td/Tdap vaccine, and who should receive it?
The Td and Tdap vaccines
both contain vaccines against tetanus (lockjaw) and diphtheria. The Tdap also
contains a vaccine against pertussis (whooping cough). Most adults are used to
getting a tetanus shot when they get a cut. Up until 2005, adolescents and
adults were not recommended to receive the pertussis vaccine due to an unacceptable
rate of negative reactions. In 2005, a new acellular pertussis vaccine became
available for both children and adults (although there are different ones for
each group using different amounts of each vaccine). Whooping cough has become a
serious problem again due to the lack of vaccination in adolescents and adults.
It is therefore recommended that all adolescents and adults receive at least one
dose of Tdap when they are due for their next tetanus shot. Health-care workers
should get one Tdap vaccination as soon as possible but at least two years since
the last tetanus shot (Td).
What is whooping cough? What is the history of whooping cough?
The disease is named for the characteristic sound produced when affected individuals attempt to inhale; the
whoop originates from the inflammation and swelling of the laryngeal structures that vibrate when there is a rapid inflow of air during inspiration. The first outbreaks of whooping cough were described in the 16th century. The bacterium responsible for the infection,
Bordetella pertussis, was not identified until 1906. In the prevaccination era (during the 1920s and 30s), there were over 250,000 cases of whooping cough per year in the U.S., with up to 9,000 deaths. In the 1940s, the pertussis vaccine, combined with diphtheria and tetanus toxoids (DTP), was introduced. By 1976, the incidence of whooping cough in the U.S. had decreased by over 99%.
During the 1980s, however, the incidence of whooping cough began to increase and has risen steadily, with epidemics typically occurring every three to five years in the U.S. In the last epidemic, which occurred in 2005, 25,616 cases were reported according to the U.S. Centers for Disease Control and Prevention (CDC). In 2008, over 13,000 cases of whooping cough were reported in the U.S., resulting in 18 deaths.
In 2010, a pertussis epidemic was declared in California. The California Department of Public Health warned in June 2010 that the state was on pace to suffer the most illnesses and deaths due to whooping cough in the past 50 years. In the previous epidemic of 2005, California recorded 3,182 cases and eight deaths.
Unimmunized or incompletely immunized young infants are particularly vulnerable to the infection and its complications, which can include pneumonia and seizures.
Can whooping cough be prevented with a vaccine?
Whooping cough commonly affects infants and young children but can be prevented by immunization with pertussis vaccine. Pertussis vaccine is most commonly given in combination with the vaccines for diphtheria and tetanus. (Pertussis is the "P" in the DTaP combination inoculation routinely given to children, and the "p" in the Tdap vaccine administered to adolescents and adults.) Since immunity from the pertussis vaccine wears off with time, many teenagers and adults get whooping cough.
For maximum protection against pertussis, children need five DTaP shots. The first three vaccinations are given at 2, 4, and 6 months of age. The fourth vaccination is given between 15
and 18 months of age, and a fifth is given when a child enters school, at 4-6 years of age. Preteens going to the doctor for their regular checkup at 11 or 12 years
of age should get a dose of the Tdap booster, and adults who didn't get Tdap as a preteen or teen should get one dose of Tdap. The easiest way for adults to ensure immunity is to get the Tdap vaccine instead of their next regular tetanus booster. (The Td shot is recommended every 10 years.)
To protect their infants, most pregnant women who were not previously vaccinated with Tdap should get one dose of Tdap postpartum before leaving the hospital or birthing center. Getting vaccinated with Tdap is especially important for mothers and families with new infants as well as all people caring for newborns. Women planning pregnancy may also choose to get vaccinated with Tdap prior to becoming pregnant.
In some cases, pregnant women may desire vaccination with the Tdap vaccine or may be at risk for acquiring whooping cough. Although the U.S. CDC states that pregnancy is not a contraindication for receiving the Tdap vaccine, data on the safety of the vaccine in pregnant women are limited. The tetanus and diphtheria (Td) components of the vaccine are considered safe for pregnant women. If the Tdap vaccine is given in pregnancy, the CDC recommends that it be given in the
second or third trimester. Pregnant women should consult their health-care provider for a discussion their individual situation regarding the pertussis vaccine.
Pneumonia is inflammation of one or both lungs with consolidation. Pneumonia is frequently but not always due to infection. The infection may be bacterial, viral, fungal or parasitic. Symptoms may include fever, chills, cough with sputum production, chest pain, and shortness of breath.
Dehydration is the excessive loss of body water. There are a number of causes of dehydration including heat exposure, prolonged vigorous exercise, and some diseases of the gastrointestinal tract. The best way to treat dehydration is to prevent it from occurring.
An upper respiratory infection is a contagious infection of the structures of the upper respiratory tract, which includes the sinuses, nasal passages, pharynx, and larynx. Common causes of an upper respiratory infection include bacteria and viruses such as rhinoviruses, group A streptococci, influenza, respiratory syncytial, whooping cough, diphtheria, and Epstein-Barre. Examples of symptoms of upper respiratory infection include sneezing, sore throat, cough, fever, and nasal congestion. Treatment of upper respiratory infection are generally with OTC medication and home remedies.
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease. Treatment of chronic cough is dependant upon the cause.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Asthma is a common disorder in which
chronic inflammation of the bronchial tubes (bronchi) makes them swell, narrowing the airways. Signs and symptoms include shortness of breath, chest tightness,
cough and wheezing.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Encephalopathy means brain disease, damage, or malfunction. Causes of encephalopathy are varied and numerous. The main symptom of encephalopathy is an altered mental state. Other symptoms include lethargy, dementia, seizures, tremors, and coma. Treatment of encephalopathy depends on the type of encephalopathy (anoxia, diabetic, Hashimoto's, hepatic, hyper - hypotensive, infectious, metabolic, infections, uremic, or Wernicke's) are examples of types of encephalopathy.
Tetanus is an often-fatal disease caused by nerve toxins produced by the common bacteria Clostridium tetani. In a seven-day period after infection, a person experiences muscle spasms, restlessness, headache, irritability, then lockjaw, and the lungs stop functioning. Tetanus is treatable with antibiotics and drainage. Sedation is often give to stop muscle spasms.
Diphtheria is an infectious disease caused by the Corynebacterium diphtheriae bacteria. The disease is transmitted via contact with airborne droplets or direct contact with skin lesions. Symptoms and signs include fever, sore throat, hoarseness, difficulty swallowing and breathing. Antibiotics and the diphtheria antitoxin are used in the treatment of diphtheria.
Drug resistance (antimicrobial resistance) is the ability of bacteria, fungi, parasites, and viruses to grow, even in the presence of a drug that would normally kill it (or limit it's growth). Drug resistance is a growing problem, particularly for infections such as MRSA, VRE (vancomycin-resistant enterococci), tuberculosis, HIV, STDs, gonorrhea, flu, pneumonia, malaria, E. coli, salmonella, Campylobacter, which causes diarrhea and gastroenteritis. Learn how to protect yourself from resistance to drugs.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
Teenagers recognize that they are developmentally between child and adult. Teen health prevention includes maintaining a healthy diet, exercising regularly, preventing injuries and screening annually for potential health conditions that could adversely affect teenage health.
Pneumonia is a lung infection that can be caused by
different types of microorganisms, including bacteria, viruses, and fungi.
Symptoms of pneumonia include cough with sputum
production, fever, and sharp chest pain on inspiration (breathing in).
Pneumonia is suspected when a doctor hears abnormal
sounds in the chest, and the diagnosis is confirmed by a chest X-ray.
Bacteria causing pneumonia can be identified by sputum
culture.
A pleural effusion is a fluid collection around the
inflamed lung.
Bacterial and fungal (but not viral)
pneumonia can be treated with antibiotics.
What is pneumonia?
Pneumonia is an infection of one or both lungs which is usually caused by bacteria, viruses, or fungi. Prior to the discovery of antibiotics, one-third of all people who developed pneumonia subsequently died fro...
The Td and Tdap vaccines
both contain vaccines against 
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