As kids and teens head back to school this month, parents will want to be more vigilant than ever about watching for signs of illness.

Not only does the fall season bring an increase in exposure to germs and the common cold, but crowded classrooms and everyday activities can be breeding grounds for more serious diseases such as meningococcal meningitis and pertussis, or whooping cough.

The incidence of whooping cough is on the rise nationwide. The United States could be headed toward its worst year in five decades with 18,000 cases reported so far this year, according to the Centers for Disease Control and Prevention. If the numbers continue at this pace, the count will be the highest since 1959 when 40,000 cases were reported for the year.

Missouri and Illinois, along with 16 other states, have whooping cough rates above the national average. Health officials are trying to figure out what's behind the increase, and some say it may be due to an evolution in the bacteria, better detection and reporting of cases, or failures in the vaccine.

While the rates for meningococcal meningitis are not as high as those for whooping cough, other concerns are causing parents and health officials to rally around vaccination against the disease.

Current public health recommendations call for vaccination at age 11 or 12 and a booster dose by age 18 — covering the years when teens are most susceptible to the disease. Activities associated with returning to school such as sharing water bottles, kissing and simply spending lots of time in close proximity to others increase the risk of contracting meningitis.

The Missouri Association of School Nurses, along with the Gateway Immunization Coalition and the St. Louis County Department of Health, has joined the Voices of Meningitis “Boost Our Rates!” initiative started by the National Association of School Nurses. The groups aim to educate parents about the dangers of meningitis and promote vaccination.

“Meningitis has been around for a long, long time, as has the vaccine. One of the reasons ... we want to get the message out, is that Missouri has the 14th lowest rate for vaccines in the country,” said Linda Neumann, RN, past president of the Missouri Association of School Nurses.

Nearly 51 percent of Missouri teens ages 13 to 17 are not vaccinated for meningitis — a number the nurses’ campaign hopes to change. Although disease totals for the year usually sit around 1,000 to 1,200 people according to Neumann, 10 percent of those who contract meningitis die from it.

“Though meningococcal meningitis is rare, it can kill an otherwise healthy child in just a single day. I learned about the potentially deadly effects of the disease in the worst possible way,” Georgia state representative and spokesperson for Voice of Meningitis, Amy Carter, said.

Carter’s brother died of meningitis while he was in high school, and now she says she is a vaccination advocate to help others prevent what happened to her family.

Unlike whooping cough and other, more common diseases, the meningitis vaccine is not required by the Missouri Department of Health and Senior Services for school enrollment. Neumann, who is a nurse at Hixson Middle School in Webster Groves, said that an immunization coalition meets with the Department of Health each year to give recommendations on which vaccinations should be required. She expects there will be a presentation on the meningitis vaccination at this year’s meeting in November.

“We’d like to see it there but it’s not up to school nurses,” Neumann said.

Carter added that even though schools may not require the meningitis vaccine, private health insurance may cover its cost because the vaccine is recommended.

“For those who don’t have insurance, there is the federally funded Vaccines for Children program where teens through the age of 18 can receive these recommended vaccinations for free or at low cost if they qualify,” she said.

The other barrier to getting kids vaccinated can sometimes be parents’ wariness of vaccinations, according to Neumann.

“(The public has) misinformation ... about the safety of vaccines, and even though it was recanted, once the information is out there it sticks in their minds,” she said.

This misinformation combined with a lack of awareness is the driving force behind the national Voices of Meningitis campaign.

“I think parents in general are not aware of vaccines. Every year we go through the same struggles of trying to get kids vaccinated for school,” Neumann said. “We’re trying to educate parents more and more because these [diseases] are preventable.”