Whooping cough cases seen in Carson City
Hospital Epidemiologist at Carson Tahoe Health
Who would have thought that in 2017 we would be seeing Pertussis (whooping cough) cases in Carson City?
If you have been in the bug business as long as I have, (39 years and counting), you learn how humbling germs can be. Just when you think you have treated or vaccinated them into the dark beyond, they come raging back, meaner and stronger than ever. Pertussis or, the disease it causes, whooping cough is such a bug. In the last few weeks, at least three cases of pertussis have been identified in our community, all three children, two of which were infants. This is highly unusual and not a normal occurrence, so let’s review the drill and learn everything we can about pertussis to remember why we need to care about it.
Pertussis is a respiratory illness caused by bacteria called Bordetella pertussis that can be extremely contagious. The infection is found only in humans but other species are responsible for infections like “kennel cough” in dogs. Pertussis is spread from person to person by coughing, sneezing or sharing air space with someone infected for a long period of time. Symptoms usually develop five to 10 days after exposure. They don’t call it the “100 day cough” for nothing… it really can last.
The infection is divided into three stages.
Stage one (catarrhal) lasts for one or two weeks with runny nose, low grade fever, mild occasional cough and this is when a patient is the most contagious.
Stage two (Paroxysmal) lasts one to six weeks with numerous rapid coughs followed by a “whoop” sound, vomiting and exhaustion. During this stage, an adult may actually pass out or even break a rib from coughing so hard for so long.
Stage three (convalescent) lasts two to three weeks and recovery is gradual as the cough lingers on. During this stage you are also more susceptible to other respiratory bugs such as influenza and pneumonia. When babies less than a year old catch pertussis, it can be very serious. About 50 percent require hospitalization, 23 percent develop pneumonia, and one percent die.
Treatment for Pertussis is antibiotics, cool mist vaporizers, respiratory support (O2 and breathing treatments), and hydration (plenty of fluids). The best way to prevent this infection is vaccination. Pertussis vaccines have been available since the late 1930s and today the vaccine is usually combined with tetanus and diphtheria in the TdaP vaccine. Babies and children should get five doses for maximum prevention given between two and 18 months. A booster dose should be given at 11 or 12 years old. Pregnant women should be vaccinated between 27 and 36 weeks of pregnancy to protect themselves and their unborn babies. Family members and Healthcare Providers who have direct contact with infants should get a booster before the infant is born to add another layer of protection around the very tiniest of us all. Remember, no vaccine is 100 percent effective and generally the Pertussis vaccine is between 80-90 percent. You can catch pertussis even if your vaccinations are current, but as with other vaccine preventable infections, the symptoms will be less severe and transmission risk will be lower.
Unlike Polio, and to some extent Measles, Pertussis has never been eradicated from the U.S. and it continues to pop-up in three- to five-year cycles. Being aware and taking necessary precautions to protect ourselves and the babies is the key to minimizing transmission. Pertussis is here – let’s fight back and get vaccinated.