Recently within the United States, there has been an outbreak of pertussis, also known as whooping cough. Of particular concern is the state of Minnesota, from where this blog is being written. As of July 20th, 2012, the Minnesota Department of Health has reported 1,881 confirmed cases of pertussis already this year. Our neighbors to the east, Wisconsin, have reported 3,169 confirmed cases of whooping cough. The State of Washington has reported 3,180 confirmed cases, being the highest number in the United States this year. Notice that I have stated confirmed cases. Some, or even many, cases of whooping cough will go unreported, as they sometimes are not diagnosed due to the symptoms in adolescents and adults simulating a bad case of the common cold. The United States has seen an alarming increase in diagnosed or confirmed whooping cough cases of approximately 11 percent in just one week (from July 14th to July 21, 2012).
“Whooping cough is thought to be on the rise for two main reasons,” says Jo DeBruycker, RN, MPH, with Affiliated Community Medical Center. “The whooping cough vaccine you receive as a child eventually wears off. This leaves adolescents and adults susceptible during an outbreak. In addition, children are not fully immune to whooping cough until they have received at least three shots. This leaves those 6 months and younger at greater risk of contracting the infection.” A recent newspaper article in the Minneapolis Star Tribune (Outbreak Brings Focus to Whooping Cough) reiterates the importance of adults making sure that they are vaccinated against pertussis if they are around children 12 months or younger, as young children and infants are the most vulnerable to the disease.
How do I know if I might have Pertussis? Once one becomes infected with whooping cough, it can take one to three weeks for signs and symptoms to appear. These signs and symptoms often resemble a mild common cold. After a week or two, symptoms become worse, where thick mucus accumulates inside your airways, causing uncontrollable coughing. Coughing jags may cause vomiting, result in red or blue face due to difficulty breathing while coughing, and cause extreme fatigue. Whooping cough gets its name by the sound of a high pitched intake of breath after an attack of coughing, which sounds like “whoop”. The “whoop” sound is characteristically heard more often in young children and infants. Persistent hacking is often the only sign that an adolescent or adult has whooping cough. Along with the persistent cough that typically lasts for approximately 100 days, other issues surrounding whooping cough include severe fatigue and cracked ribs, both due to severe coughing attacks.
How does pertussis spread? Pertussis or whooping cough is spread through the air as droplets, from those already infected, who sneeze or cough. Whooping cough is highly contagious.
As stated earlier, immunity from childhood vaccination and natural disease wanes with time; therefore, adolescents and adults who have not received a Tdap booster vaccination can become infected or re-infected. US travelers are not at increased risk for disease specifically because of international travel, but they are at risk if they come in close contact with infected people. Infants too young to be protected by a complete vaccination series are at highest risk for severe pertussis that often requires hospitalization.
The best way to protect children against pertussis is with DTaP vaccinations (immunizations at two months, four months, and six months of age, followed with booster shots at twelve to eighteen months and at four or five years of age).
TDaP also protects against pertussis (notice the difference DTaP and TDaP). A single dose of TDaP vaccine should be administered to children 7 through 10 years of age who may be under immunized with DTaP or who have an incomplete history.
The Center of Disease Control (CDC) and American Academy of Pediatrics (AAP) continues to recommend vaccination of adolescents. Pregnant women should also receive the vaccine. A single dose of TDaP should be given to adults who have or will have contact with infants, even if they are older than 65, and for health care workers of any age. If you are an adult who is due for a TD booster, a onetime adult TDaP is recommended in place of the TD booster.
Other Tips to Prevent Pertussis
Other than vaccination and booster immunizations with TDaP, there is no effective way to prevent pertussis. The bacterium is so incredibly contagious, and the symptoms are too similar to those of the common cold, to realistically stop its spread.
However there are two things you can do to reduce the symptoms and spread of whooping cough, should this bacteria show up within your circle of family or friends.
- Wash your hands often. Hand hygiene is very important. Whenever possible, wash hands, use alcohol based rubs, or both, after touching nasal secretions.
- Cover your nose and mouth when coughing or sneezing. Teach and encourage children to do the same. Teach correct methods of covering a cough or sneeze, i.e. with a disposable tissue or sleeve of an arm.
In closing, trying to prevent the spread of whooping cough without adequate vaccination is most likely a losing battle. People are social beings and intimacy at home is natural. Pertussis vaccination remains the single most effective strategy against infection. Further information from the CDC: Pertussis and Recommended Vaccination Schedules
International Travel Care educates, vaccinates, and provides travel medications, such as anti-malarial medications, for those traveling outside of the United States. We also provide regular wellness vaccines such as TDaP and flu shots.
We are currently booking flu and TDaP clinics for corporations, schools, church group, or any other group interested in protecting their health from vaccine preventable diseases. To book your group vaccine clinic contact us at 952-405-8812 or submit a request via our Contact page.
Kari L. Johnke-Henzler, RN, Travel Health Specialist