YPSILANTI, Mich. - The Washtenaw County Public Health Department said Tuesday that it was still seeing cases of pertussis (whooping cough).
Reports of new cases have remained steady, even though the school year has ended. Close contact among school-age children in summer activities, including camps, may be contributing to the continued spread of illness. Public Health encourages heightened awareness at this time. Early treatment with antibiotics can make the infection less severe and prevent the spread of illness to others. Vaccination may also prevent pertussis infection or reduce the severity of illness.
To date, Washtenaw County has 104 cases of confirmed and probable pertussis this year. This is about four times the number of cases typically seen in a year in the county. Fortunately, there has been only one hospitalization and no deaths.
"Pertussis is making a come-back," says Dr. Alice Penrose, MD, MPH, Medical Director for Public Health. "Many doctors have never seen whooping cough until recently. The patients are getting information from the health department and online, and are educating their doctors in some cases."
What is Pertussis?
Pertussis is a very contagious disease of the respiratory tract caused by bacteria called Bordetella pertussis. Pertussis is also known as "whooping cough" due to the "whoop" sound made when the infected person tries to breathe after hard coughing and choking spells. Children younger than six months of age may not have the strength to have a "whoop." Also, many adults and teenagers with pertussis do not have a classic "whoop."
The infection starts out much like the common cold and may include a low grade fever or runny nose. After one or two weeks, pertussis can become a series of severe coughing fits that continues for weeks. Fits of coughing can cause vomiting or lack of oxygen. Pertussis can cause serious illness in infants, children and adults. In children less than one year old, complications include pneumonia, convulsions and, in rare cases, brain damage. The majority of deaths from pertussis occur in infants younger than two months of age.
Call your health care provider if you have any of these symptoms:
- Unusual cough lasting 7 days or more (with or without "whoop")
Cough that comes in bursts (intermittent)
Vomiting after coughing spells
Children under one year of age are the most susceptible to the disease, in part because vaccination does not begin until two months of age. The current recommendation is for women to receive a pertussis vaccination with each pregnancy, so that the immunity is transferred to the fetus in the womb. Decreasing the risk of exposure to the illness during that first year of life is also important. Pertussis is very contagious. Individuals with mild forms of illness may unknowingly spread the infection to others. It is very important to identify, isolate and treat even mild cases, so that infants who are not yet fully immunized will not be exposed.
Before the pertussis vaccine was developed, about 200,000 people were infected each year in the U.S. and 8,000 died, mostly children.
In the six years from 2004 to 2010, only 148 Americans died of whooping cough, 135 of them under three months of age. The total number of infections per year has decreased about 90% since vaccination began.
Unlike many childhood illnesses, having the disease does not impart life-long immunity, nor does the vaccine. The vaccine does decrease the severity of symptoms even if it cannot prevent the disease altogether, according to the Centers for Disease Control and Prevention (CDC).
Washtenaw County Public Health communicable disease nurses are working to identify new cases as quickly as possible and notify all close contacts. Parents and physicians need to know that
- Full pertussis vaccination does not rule out the possibility of pertussis. It may mask the classic symptoms of the "whoop" and vomiting after coughing.
- Anyone with a prolonged cough that occurs in fits should be tested for pertussis and started on antibiotics until the results are available.
- Close contacts, such as family members, of confirmed cases also need antibiotics in order to prevent illness, even if they have been vaccinated.
- Confirmed cases need to stay home until they have received five days of antibiotics
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