Medicine: A Comeback for Whooping Cough

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When she was 5 1/2 months old, Traci Cohn of Rockville, Md., developed a 104 degrees F fever and cried inconsolably for three days. Ever since that illness Traci, now 17, has been mentally retarded. Her family and one of her doctors believe that the fever and subsequent mental damage were the direct result of the pertussis, or whooping cough, inoculations that she received in the first months of her life.

Whooping cough, named for the distinctive sound made by its victims as they gasp for air between bouts of violent coughing, was until the 1940s a major killer of children. Caused by a bacterial infection that increases the amount of mucus in the lungs, the disease sometimes results in convulsions and death. Over the past four decades, however, pertussis has been largely subdued in developed nations by mass inoculations with a vaccine made from killed pertussis bacteria. Now doctors annually pump some 18 million doses of the vaccine into U.S. children--usually in the form of a D.P.T. shot, so called because it also provides protection against diphtheria and tetanus. Some 40 states require children to have D.P.T. inoculations before they are allowed to enter school.

Despite these efforts, the Centers for Disease Control in Atlanta reports that the incidence of whooping cough is increasing; the latest figures show that the number of U.S. cases has nearly doubled in the past three years, from 1,895 in 1982 to 3,275 in 1985. Meanwhile, health officials are concerned that more and more parents, aware of cases like Traci's, will refuse to allow their youngsters to be inoculated.

Minor reactions to the vaccine, such as redness and swelling, are common. Permanent brain damage, according to one study, occurs only once in about every 300,000 inoculations, death even less frequently. Researchers suspect that these severe complications--which can include convulsions, shock, loss of muscle control and fever--are caused by bacterial toxins. Still, most doctors insist that the shots are worth the risks. Martin Smith, president of the American Academy of Pediatrics, calculates that the chances of suffering serious damage from whooping cough are ten times greater than having damaging side effects from the vaccine. Says Dr. Peter Patriarca of the CDC's immunization division: "There is no question that the vaccine has more side effects than any other vaccine. But it's a matter of risk vs. benefits."