Number of Pertussis Cases Spiking in Several States
According to the American Medical Association (AMA), nearly 10,000 cases of pertussis had been reported to the Centers for Disease Control and Prevention by the end of September. This is a significant increase over the nearly 6,000 reported by this time last year. Much of the increase, reports the AMA, is accounted for by outbreaks in the Midwest, New England, and Mid-Atlantic. Wisconsin, for example, had a total of 215 cases last year, but has tallied more than 1,200 this year.

Blame for the increase has been placed on the pertussis vaccine’s waning effectiveness. Most children receive their last pertussis shot by age 6 and lose much of the protection it provides within a decade. Public health experts also believe that improved testing technology has enabled more accurate detection of more cases. As well, some states have improved public health communication, which has led to increased awareness. Heather Weaver, immunization program manager at the North Dakota Department of Health, says, “We had a lot of testing, and the more we test, the more we’re going to find.”

Exercise and Respiratory Treatments May Be Best in Afternoon
Circadian rhythms, the body’s biological processes that repeat in 24-hour cycles, may have a significant effect on a person’s lung function and ultimately help determine the best time of day for exercise and the administration of medications and medical procedures.

In a new study presented at CHEST 2004, the 70th annual international scientific assembly of the American College of Chest Physicians (ACCP), lung function was found to have a natural circadian rhythm, where it is at its peak during the late afternoon hours and at its lowest around midday.

Results from the study showed that patients’ overall airway resistance was at its most prominent around 12:00 p.m. but reached its minimum between 4:00 to 5:00 p.m., showing that lung function was at its best in the late afternoon.

"Our study finds that lung function has its own rhythm that may govern how much energy we exert throughout the day and the best times to engage in certain activities," says Boris I. Medarov, MD, Long Island Jewish Medical Center. "We often associate the end of the work day with being tired and less motivated for physical exertion; however, lung function seems to be at its best during this time. As a result, exercising or engaging in other physical activities in the late afternoon may help us to achieve optimal performance."

Dental Plaque Associated With Respiratory Infection in Elderly
A new study by researchers at the University of Buffalo says dental plaques, commonly found in institutionalized elderly patients, may often house respiratory pathogens responsible for hospital-acquired pneumonia. Of 49 critically ill nursing home residents who required intensive treatment in the course of the study, researchers found that 57% had aerobic pathogens in their dental plaques, including pathogens commonly found in elderly patients with severe pneumonia, and 29% the study’s participants developed hospital acquired pneumonia.

San Diego Host to NAMDRC
The National Association for Medical Direction of Respiratory Care will hold its 28th Annual Meeting & Educational Conference on March 17-19, 2005, at the Rancho Bernardo Inn in San Diego. “Essentials in Pulmonary Medicine 2005: A Review of Advancements by Thought Leaders in Pulmonary, Critical Care & Sleep Medicine” will provide a unique educational opportunity for physicians and other professionals in pulmonary care, critical care, and sleep medicine. Joseph W. Sokolowski, Jr, MD, program chair, has designed what promises to be an outstanding program with faculty from the pulmonary, critical care, and sleep medicine communities. Three half-day sessions will be devoted to recent clinical and management advancements in these areas; and attendees also will be brought up to date on economic, regulatory, and legal perspectives that will help them deal with the ever-changing health care system.

For more information, visit NAMDRC’s Web site,

Chronic Sinusitis Sufferers Have Enhanced Immune Responses to Fungi
Scientists supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, have discovered that people with chronic sinus inflammation have an exaggerated immune response to common airborne fungi.

"The study is the first to show a possible immunologic basis for chronic sinusitis, an important starting point to understand the etiology of the illness," says Marshall Plaut, MD, chief of NIAID’s allergic mechanisms section.

The research revealed that the released cytokines, immune-modulating chemicals, represent both major classes of cytokines—interferon-gamma is in the Th1 group, and IL-5 and IL-13 are in the Th2 class, Hirohito Kita, MD says. This is notable because scientists have thought that allergic reactions involve only Th2 cytokines.

The current findings of this study add to an evolving understanding of allergic diseases that suggests symptoms may stem from a combination of Th1 and Th2 cytokines.