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Your children’s health: preventing and addressing pertussis (whooping cough)

December 15, 2014

According to the Centers for Disease Control and Prevention (CDC), whooping cough (pertussis) is cyclical, peaking every three to five years. Since the 1980s, the number of reported pertussis cases has gradually increased in the United States. In 2005, more than 25,000 cases of pertussis were reported throughout the nation, the highest number since 1959.

For some states, there has been a spike in pertussis cases recently. For example, as of December 2014, the number of cases in California is five times greater than baseline levels, prompting the state to declare a pertussis epidemic, with infants affected most significantly. In 2012, New York was ranked third highest in the United States for pertussis.

Several factors are thought to be affecting the uptick in cases: waning immunity, increasing numbers of unvaccinated children and adults and improved awareness of the resurgence of pertussis, leading to improved reporting and diagnosis.

Pertussis is a highly contagious disease that is spread through the air by cough. It begins with cold symptoms and a cough that can worsen within one to two weeks. According to the New York State Department of Health, pertussis can lead to prolonged hospitalizations and be particularly dangerous for infants.

Pertussis can affect people at any age. Children who are too young to be fully vaccinated (vaccinations typically begin at two months of age) and those who have not yet completed the series of vaccines are at highest risk for severe illness. Infants — especially those younger than six months — are most likely to have severe symptoms if they develop pertussis. When possible, young infants should be kept away from people with a cough.

Children who have been around someone with pertussis could become sick, even if their shots are up to date.

Symptoms of pertussis

Pertussis symptoms usually include a long series of coughs (“coughing fits”) followed by a whooping noise. However, older children, adults and very young infants might not develop the whooping sound. The cough is often worse at night and cough medicines usually do not help alleviate it.

Other symptoms of pertussis include a slight fever, vomiting, turning blue or difficulty breathing.

Major complications of pertussis are more common among infants and young children and could include pneumonia, middle-ear infection, loss of appetite and sleep disturbances.

Parents who suspect their child has been exposed to someone with pertussis should contact their family physician. Antibiotics might prevent the child from becoming ill. If the child is already sick, giving antibiotics early can help shorten the duration of the illness and lessen the chances of the disease being spread to others.

If untreated, a person can transmit pertussis from the onset of symptoms to three weeks after the onset of coughing episodes. The period of communicability is reduced to five days after treatment with antibiotics.

Notifying others of illness

According to the CDC, if a child is diagnosed with pertussis by his or her doctor, parents should notify the child’s school.

School nurses then call their local health departments to verify that the student has, indeed, been diagnosed with pertussis. Health officials are careful not to report suspected cases, only reacting to cases that have been formally diagnosed with a lab test.

Once doctors diagnose pertussis, they also are required to report it to their county health departments. County health departments, however, also receive notification through the New York State Electronic Laboratory System, to which the State Department of Health also is connected.

Once a case has been confirmed, the child’s school alerts parents of children who have been in contact with the affected student. Privacy laws, however, prohibit the school from releasing any information that would reveal the identity of the sick student. Letters home, therefore, likely will only state which building or grade level the child is in.

County health departments often work with the doctor to follow up with the family to make sure the proper care is being carried out and do what they call “contact tracing,” or notifying those who might have been exposed to the disease.

School officials from Monticello Central School District likely will request that parents keep their children home from school and activities, such as sports or play groups, until children have been on antibiotics for five days to treat pertussis.

If parents been notified their child has been exposed to someone infected with pertussis, they should watch for symptoms, county health officials said. Visit the doctor if a child starts to exhibit cold-like symptoms and a mild cough or fever. 

Preventing pertussis with vaccinations

According to the CDC, neither vaccination nor natural infection with pertussis guarantees lifelong protective immunity against the disease. Because immunity decreases after five to 10 years from the last pertussis vaccine dose, older children, adolescents and adults are at risk of becoming infected.

However, vaccination is the best protection against the disease and the number of cases is still far fewer than before vaccines became available. The CDC recommends getting all children and adults fully vaccinated against pertussis.

In New York state, students attending school are required to have four to five pertussis vaccinations to enter kindergarten, and those born after 1994 would need to receive a booster before entering sixth grade. See http://www.health.ny.gov/publications/2370.pdf for specific vaccination requirements.

Other prevention tips

Pertussis is transmitted by coughing and sneezing while in close contact with others, so good hygiene helps prevent the illness from spreading. Parents can:

• Remind children to cover their noses with a tissue when they cough or sneeze and throw away used tissues.
• Have children wash hands frequently with soap and water for at least 20 seconds.
• Disinfect frequently touched surfaces and shared items at least once per day.
• Keep children at home if they are coughing, sneezing or have low-grade fevers.

Additional resources:

CDC’s pertussis homepage: http://www.cdc.gov/Pertussis/about/index.html

Fact sheet on pertussis from the NYS Health Department: http://www.health.ny.gov/diseases/communicable/pertussis/fact_sheet.htm

This information is shared from Capital Region BOCES Communications Service School Communications Portfolio. All rights reserved.