As summer comes to a close, many parents are preparing their children to return to school. Any back to school plan will probably include a trip to the doctor or the neighborhood pharmacist to receive vaccinations. While children are commonly vaccinated to protect against chicken pox, measles and polio , one health threat often overlooked is pertussis. The spread of pertussis, also known as the ?whooping cough?, declined after widespread use of the vaccine began during the 1940s. However, since 1990 the illness, characterized by severe coughing, has been on the rise, particularly among older adolescents and adults who may have developed immunity to early vaccinations. Many adults do not realize that they are carriers of the disease. The illness spreads quickly when a sick patient sneezes, coughs or even talks and can have serious consequences for infants and toddlers who are exposed. Until recently, there was no pertussis containing vaccine approved in the United States for adolescents and adults.