Don't take a chance when it comes to pertussis. It's a fact: Whooping cough is on the rise again.
And anyone who may be near infants should be inoculated for the disease.
Dr. Donald Middleton, an immunizations expert and a professor of family medicine and vice president of the University of Pittsburgh's St. Margaret Residency Education Program says the inoculation is important.
"They really need to come in for the shot," Middleton said. "The first thing I did when I found out I was going to be a grandfather was to (immunize myself)."
The disease - which causes inflammation of the throat and affects respiratory muscles - can be fatal for infants, Middleton said.
The bacteria that causes whooping cough can be transmitted through touch or close proximity to someone who has the disease.
"It's extremely contagious," Middleton said. Pertussis cases seem to peak every three to five years, since vaccines do not produce lifelong immunity, Middleton said.
Then the reduced levels of antibodies help lead to additional illness. Children with whooping cough develop an upper respiratory infection and are not able to take in enough oxygen, according to Mary Carre, a nurse practitioner who manages the North Penn Visiting Nurse Association's children's clinic, near Lansdale Hospital in Hatfield Township.
Those who come down with whooping cough suffer from severe coughing spells, vomiting and disturbed sleep, according to Jane Cero, a registered nurse with the VNA .
Once someone has the disease, this can lead to weight loss, rib fractures and loss of consciousness caused by the violent coughing. Those who are suffering from whooping cough often need to take deep breaths after coughing fits, which result in a "whooping" sound, according to the U.S. Centers for Disease Control and Prevention's website. In 2009, nearly 17,000 cases of pertussis were reported, according to the federal website. Diagnoses of whooping cough appear to be on the rise, Middleton said.
From January to Nov. 2, more than 6,400 cases of pertussis - the highest numbers since 1950 - were reported in California, according to the CDC's website.
Those statistics - which included the death of 10 infants - put the entire medical community on alert, according to Middleton. "That was a disaster," he said. Infants receive the pertussis vaccine at ages 2, 4 and 6 months, according to Middleton.
Between April and August, the Pennsylvania Department of Health identified an increase in pertussis activity, according to a health advisory alert.
The alert references a four-fold rise in cases, with a focus on the Philadelphia suburbs. So far this year, the VNA has received a few calls from new fathers about receiving the immunization, according to Cero.
That's in contrast to last year, she said, when the VNA received no calls. Though the VNA's children's clinic has not treated an infected child, heath-care providers remain vigilant about treating symptoms, according to Carre.
She said the staff makes sure all newborns follow up with the primary care provider.
"Not everyone has the classic symptoms," Carre said. "If you test positive, you've already passed the disease to someone else."
WHO GETS PERTUSSIS?
Pertussis can occur at any age. Severe illness is more common in young children who have not been immunized. Older immunized children or adults with pertussis have milder symptoms. The diagnosis of pertussis should be considered for older children or adults with persistent coughs to ensure they do not pass the infection on to young children.
WHAT ARE THE SYMPTOMS OF PERTUSSIS?
Pertussis begins as a mild upper respiratory infection. Initially, symptoms resemble those of a common cold, including sneezing, runny nose, low-grade fever and a mild cough. Within two weeks, the cough becomes more severe and is characterized by episodes of numerous rapid coughs followed by a crowing or high-pitched whoop. Thick, clear mucus may be discharged. These episodes may recur for one to two months, and are more frequent at night. Young children who have not been immunized have the most severe symptoms. Infants less than six months of age, adolescents and adults often don't have the characteristic whoop.
Therefore, a person with a cough that lasts more than a week without improvement should see a health care provider to ensure the cough is not pertussis.
WHEN AND FOR HOW LONG IS A PERSON ABLE TO SPREAD PERTUSSIS?/p>
A person can transmit pertussis from seven days following exposure to an infected person to three weeks after the onset of coughing episodes. The period of communicability is reduced to between five and seven days when antibiotic therapy is begun.
WHAT IS THE VACCINE FOR PERTUSSIS?
The vaccine for pertussis is usually given in combination with diphtheria and tetanus. Immunization authorities recommend that DTP (diphtheria, tetanus, pertussis) vaccines be given at two, four, six and 12-15 months of age and between four and six years of age. A vaccine with an acellular pertussis component is now licensed for infants and may be used for the first three doses of the vaccination series as well as the booster doses.
WHAT CAN BE DONE TO PREVENT THE SPREAD OF PERTUSSIS?
The single most effective control measure is maintaining the highest possible level of immunization in the community. Anyone who comes into close contact with a person who has pertussis should receive antibiotics to prevent spread of the disease. Treatment of cases with certain antibiotics such as erythromycin can shorten the contagious period. People who have or may have pertussis should stay away from young children and infants until properly treated.
A combination tetanus, diphtheria and acellular pertussis vaccine Tdap (Adacel sanofi pasteur) is recommended for use in all 11- to 12-year- olds and 15-year-olds at high school entry. In adults under 65, Tdap should be given every 10 years to maintain immunity.
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