Highly Contagious: Pertussis Makes Its Rounds in Crawford County

At the end of last summer, The Pennsylvania Department of Health issued a health advisory regarding the potential outbreak of pertussis, commonly known as whooping cough. Although several months have since passed, the health department is still seeing increased cases of the disease, which can spread rapidly throughout the population with little to no warning.
According to the Centers for Disease Control and Prevention, pertussis is a common disease that often shows up in outbreaks every 3 to 5 years. In 2009, nearly 17,000 cases were reported to the CDC, and just last year in California, 19 children under age 2 died from the disease. In fact, California saw the largest number of reported pertussis cases (8,383) since 1947, when 9,935 people contracted the disease. In Pennsylvania, 508 people had suffered from pertussis, according to a 2010 report from the Pennsylvania Health Department.

In Crawford County, the number of reported pertussis cases continues to rise.  While the county is not in an official “outbreak,” the region is not immune to localized outbreaks by municipality or school district.  In a 2010 report, 27 cases of pertussis were reported in the county, which is at a rate of 10.1 per 100,000 people. As we move into 2011, the health department notes that more cases are routinely being identified.
Furthermore, to our southeast, neighboring Venango County is suffering from double the incidence rate of pertussis than reported in Crawford over the past few months. The health department statistics show that Venango County saw 5 cases in the past year and previously had not seen any.  While the number of cases doesn’t seem like many, this number when compared to the total population of Venango County puts the county’s pertussis incidence rate at 20 per 100,000 people. To our south in Mercer County, 85 people were diagnosed with the disease, which is a rate of 24.1 per 100,000, and to our north, Erie County has seen 48 cases with a rate of 5.7 per 100,000 people.
Considering the highly contagious nature of pertussis, the disease could very quickly infect the residents of Crawford County. Pertussis is caused by a bacterium called Bordetella Pertussis, which attaches to the cilia in the lungs causing damage and inflammation. It’s quickly transmitted through close contact with others through sneezing or coughing – much like the common cold or influenza. Symptoms are often not noticeable for 7-10 days after the initial infection and often mimic a cold or the flu. The difference is that these symptoms last for 1-2 weeks and cause coughing fits that sound like a high-pitched “whoop.” In infants, the disease can cause apnea associated with serious breathing difficulties that lead to death.
There is an easy way to prevent pertussis infection – being vaccinated with Tdap, which protects against tetanus, diphtheria-acellular, pertussis . Because of the urgency to halt any further spread of the disease, the CDC’s Advisory Committee on Immunization Practices recently issued new guidelines for vaccine administration. Here is a quick status report:

·        Children ages 7-9 should receive a one-time dose of the vaccine if they have never completed the original series begun at infancy.

·        Adolescents ages 10-18 years should receive a one-time dose of the vaccine.

·        Adults ages 19 through 65 years should receive a one-time dose – especially if prior immunization records against pertussis are unknown.

·        Adults age 65 and older who come in contact with infants and children should receive a one-time dose.

The traditional immunization schedule for children under age 7 for pertussis involves a series of four doses of vaccine, given at 2, 4 and 6 months of age. The fourth dose is given at least 6 months after the third, usually at 12-15 months of age.  A booster dose is given between the ages of 4-6 years, prior to school entry. 
If you are uncertain about your vaccination history or needs, check with your primary care physician.  You can find out more details on pertussis and immunization schedules at the CDC’s website: www/cdc.gov.

References

 Centers for Disease Control and Prevention. (2011). Pertussis (Whooping Cough). Retrieved February 2, 2011 from http://www.cdc.gov/pertussis/outbreaks.html.

Centers for Disease Control and Prevention. (2011). Recommended immunization schedule for persons aged 0-6 years: United States 2011. Retrieved February 2, 2011 http://www.cdc.gov/vaccines/recs/schedules/downloads/child/2011/11_0-6yrs-schedule-pr.pdf.

Pennsylvania Department of Health. (2010). Pennsylvania health profiles. Retrieved February 10, 2011 from http://www.portal.state.pa.us/portal/server.pt?open=space&name=Dir&psname=SearchResult&psid=12&cached=true&in_hi_userid=2&control=OpenSubFolder&subfolderID=156603&DirMode=1

Pennsylvania Department of Health. (2011). Pennsylvania pertussis incidence rates by county: 2010. Pennsylvania Epi Notes, 1(1), 2.