Cases of pertussis, also known as whooping cough, are on the rise in the U.S., recently reaching their highest level in 50 years. The disease can be serious or even fatal to newborns who have not yet received vaccinations.

Effective vaccines against pertussis have been available for many decades, but that vaccine protection can wear off over time. A new University of Michigan poll shows that 61 percent of adults say they don’t know when they were last vaccinated against pertussis, which could mean they might be unwittingly exposing vulnerable babies to the disease.

Only 20 percent of adults reported that they received the pertussis vaccine less than 10 years ago (the recommended time frame) and 19 percent said they were vaccinated more than 10 years ago.

“Pertussis is a very preventable disease,” says Matthew M. Davis, M.D., M.A.P.P., director of the C.S. Mott Children’s Hospital National Poll on Children’s Health.

“But many adults may think their childhood vaccinations still are protecting them against pertussis. Findings from this poll show that few adults have received a booster shot within the recommended 10-year time frame and in fact, two-thirds told us they were not aware of their vaccination status.”

Pertussis easily spreads within households, day care facilities, schools and neighborhoods and is most often serious in infants and young children. In fact, the majority of deaths from pertussis occur in children less than 3 months old.

The poll found, however, broad support for parents to insist their newborns aren’t exposed to those who might not be current on their pertussis vaccine.

The majority of adults polled (72%) strongly agree or agree that parents have the right to insist that visitors receive the pertussis vaccine before visiting a newborn baby in the hospital. Nearly two-thirds (61%) of adults strongly agree or agree that parents should make sure all adults receive the pertussis vaccine before visiting a newborn baby at home.

Pertussis vaccines are recommended for teens and adults (known as the “Tdap” vaccine), including pregnant women. Boosting immunity against pertussis among teens and adults is especially important for protecting newborns against the disease. Most infants who fall sick with pertussis got the illness from an older child or adult with pertussis.


“Welcoming a baby to the family is a wonderful time, and no one would want to put an infant at risk. So the results of this poll are encouraging because they indicate some awareness that visitors need to be protected against this disease,” Davis says.

“Teens and adults who have received the Tdap vaccine are less likely to get whooping cough themselves, and therefore less likely to spread whooping cough to other people — including infants who have not yet been protected by the recommended pertussis vaccinations.”

Davis says he hopes the awareness among parents will increase the numbers of people seeking a booster vaccine.

“Expectant parents should have a conversation about pertussis vaccine with their family and close friends BEFORE the baby is born, to allow time for them to get their pertussis vaccine up to date,” Davis says.

“If parents begin to take this approach, it may have a very positive impact decreasing the number of newborns who become severely ill or die as a result of pertussis.”

Beaumont-led, national study seeks answers

After three years of research, a multicenter, national research study led by Beaumont orthopedic surgeon and sports medicine specialist, Joseph Guettler, M.D., may have some answers as to why youth baseball pitching injuries continue to rise despite the implementation of nationally recommended pitching limits. In fact, serious pitching injuries requiring surgery have skyrocketed with one estimate reporting serious throwing injuries are occurring 16 times more often today than just 30 years ago.

Joseph Guettler, M.D.
Beaumont Sports Medicine
“Our research team and colleagues from around the country, saw several recurring themes,” says Dr. Guettler. “It became very clear that dangerous pitching behavior is occurring among pitchers as young as little league all the way through their high school years. And, the blame doesn’t usually lie with the leagues or coaches. Most were found to be adhering to nationally recognized guidelines for pitch limits and rest. It seems much of the blame lies with behavior of parents and their kids.”

Some of the findings concluded that contrary to national guidelines limiting pitches thrown, 13.3 percent of pitchers pitched competitively for more than 8 months of the year, 40 percent pitched in a league without pitch counts or limits, 56.6 percent pitched on back-to-back days, and 19 percent pitched more than one game in the same day. Nearly one-third of these pitchers pitched for more than one team during the same season; one-third played only baseball and 10 percent also played catcher on the same team, another high-volume throwing position.

“The most prevalent reasons for arm pain and tiredness can be boiled down to five major issues,” Guettler adds. “The following behaviors can lead to arm pain and tiredness which can then lead to the most significant shoulder and elbow injuries.”

Pitching for more than one team during the same season
Pitching more than one game during the same day
Pitching on back-to-back days
Pitching in a league without pitch counts or playing year-round
Throwing curve balls before high school
A total of 754 pitchers between the ages of 9 and 18 participated in this national youth baseball study where all regions of the United States were represented. The average age of the pitchers was 14.1. The average age of first throwing curve balls was 12.2. The boys pitched on average 5.2 months per year, and when in-season, threw 5.4 innings per week. More than half pitched for a travel club, and 41.9 percent attended a pitching camp. Most importantly, one-third of the pitchers reported having a pitching-related injury in the past 12 months, seven out of 10 reported significant arm tiredness in the past 12 months, and nearly 40 percent reported significant arm pain within the past 12 months.

To date, this is the largest study of its kind. It is also the first study to include all regions of the United States. The American Orthopedic Society for Sports Medicine sponsored the study.

Dr. Guettler says that the first step to bringing down the number of pitching injuries can be remembered with a simple, newly coined “Rule of Ones.”

It means one game a day, one day of pitching then rest, one position at a time during a pitched game, one team at a time, only one pitch before high school, and at least one season of some other organized sport. And parents, if your young pitcher mentions that his arm is ‘sore’ or ‘tired’ – let him take some time off. One complaint of arm soreness or tiredness equals on

There is a good reason why junk food tastes so good but is so bad for you. That reason is salt. Not just salt, but processed or refined salt. So, what is the difference between refined and unrefined salt, and why is refined salt so bad for you?

Unrefined salt is natural salt from the sea and contains over 80 minerals and elements that are natural and good for the body. Refined salt is salt that has been altered by man to improve the product's shelf life. Chemicals are added that contain anti-caking, free flowing, or conditioning agents, such as sodium ferrocyanide, ammonium citrate, and aluminum silicate. The minerals and elements that are good for you are removed in the refining process.

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ANN ARBOR, Mich. — In an age when evidence-based care is increasingly important, how trustworthy are current clinical practice guidelines?

Researchers at the University of Michigan Comprehensive Cancer Center looked at 169 cancer clinical practice guidelines for lung, breast, prostate and colorectal cancers and found that none of the guidelines fully met standards set in 2011 by the Institute of Medicine. Of eight criteria, the guidelines on average met fewer than three.

“None of the current guidelines we looked at meet all of the standards, but some of these are really good guidelines. It begs the question: How pragmatic are the Institute of Medicine standards? In some ways, are these standards too strict?” says lead study author Sandra Wong, M.D., M.S., associate professor of surgery at the University of Michigan Medical School.

The IOM standards for clinical practice guidelines were developed to ensure that guidelines truly reflect the best quality of care. The standards cover eight criteria, including disclosing conflicts of interest, using systematic reviews of the literature, seeking external review and updating recommendations regularly.

In this new study, published in the Journal of Clinical Oncology, researchers reviewed clinical practice guidelines for the four leading causes of cancer deaths – lung, colorectal, breast and prostate cancer. Guidelines covered recommendations for screening, diagnosis, treatment or follow-up care.

On average, guidelines met 2.75 of 8 major criteria and 8.24 of 20 sub-criteria. The most common gaps were in managing conflict of interest and including patients or other lay people in the process.

“The IOM was trying to define what you need to have trustworthy guidelines. But if a group does not include a forum for public comment on the guidelines, does that make the guideline less trustworthy? Is that as important as whether they incorporate a systematic review of the literature? One consideration is that perhaps all standards should not be weighted the same across the board,” Wong says.

She also suggests creating a balance between ideal standards and what is practical to ensure guidelines can be put in place in a timely manner. Some guidelines already take more than a year to create.

“Everybody is much more worried about quality standards and evidence based care. Clinicians are inundated with a lot of information and must be able to rely on guidelines produced by major professional organizations. At the same time, standards must ensure a practical and pragmatic approach to creating guidelines,” Wong says.