HUNTERDON COUNTY DEPARTMENT OF HEALTH
For more information, contact Carl Rachel at 908-788-1351
PERTUSSIS OUTBREAK BEING INVESTIGATEDThe county health department is currently investigating an outbreak of pertussis, coordinating its examination with the New Jersey Department of Health and Senior Services, the Hunterdon Medical Center, and local schools. The health department also notified physicians throughout Hunterdon and requested them to do enhanced pertussis surveillance throughout the holidays.
PERTUSSIS Q & A
(from Guidelines for the Control of Pertussis Outbreaks, 2000;
with amendments made in 2005 and 2006)
WHAT IS PERTUSSIS?
Pertussis, also called “whooping cough,” is a very contagious disease caused by bacteria (germs). Pertussis is usually mild in older children and adults, but it often causes serious problems in very young children (i.e., infants less than one year of age).
WHAT ARE THE SYMPTOMS OF PERTIUSSIS?
Pertussis symptoms have two stages. The first stage (which lasts 1 to 2 weeks) begins like a cold, with a runny nose, sneezing, mild fever, and cough which slowly gets worse. The second stage is marked by uncontrolled coughing spells and a whooping noise (in young children) when the person inhales. During severe coughing spells, a person may vomit or become blue in the face from lack of air. Between coughing spells, the person often appears to be well. The coughing spells may be so bad that it is hard for babies to eat, drink of breath. This coughing stage may last for 6 or more weeks. Adults, teens, and vaccinated children often have milder symptoms that mimic bronchitis or asthma. Some infants may only have apnea (failure to breath), and may die from this.
HOW IS PERTUSSIS SPREAD?
The germs that cause pertussis live in the nose, mouth and throat, and are sprayed into the air when an infected person sneezes, coughs or talks. Other people nearby can then inhale the germs. Touching a tissue or sharing a cup used by someone with pertussis can also spread the disease. The first symptoms usually appear about 7 to 10 days after a person is exposed. Infants often get pertussis from older children or adults.
WHO GETS PERTUSSIS?
Pertussis is most common among infants less than a year old, but anyone can get it. Pertussis can be hard to diagnose in very young infants, teens and adults because their symptoms often look like a cold with a nagging cough.
IS PERTUSSIS DANGEROUS?
It can be, especially for infants. Pertussis can cause breathing problems (apnea), pneumonia, and swelling of the brain (encephalopathy), which can lead to seizures and brain damage. Pertussis can also cause death (rarely), especially in very young infants.
HOW IS PERTUSSIS DIAGNOSED?
A doctor may think a patient has pertussis because of the symptoms, but a sample of mucus must be taken from the back of the nose for testing. This sample is then tested by a laboratory to determine whether the patient has pertussis.
HOW IS PERTUSSIS TREATED?
Antibiotics can make the disease milder if they are started early enough, and will help to prevent transmission of the illness to others. Anyone who is exposed to pertussis should also be given antibiotics to prevent the disease, even if they were vaccinated. In addition, it is helpful to get plenty of rest and fluids. Treatment for young children may include supportive therapy such as fluids, oxygen, and mild sedation to help the child during the prolonged period of coughing.
CAN PERTUSSIS BE PREVENTED?
Yes, there is a vaccine to prevent pertussis. It is given along with diphtheria and tetanus vaccines in the same shot (called DTaP). Five doses of vaccine, given in a series starting at 2 months of age, are needed to protect a child from pertussis. The vaccine works for most children, but it wears off after a number of years. The vaccine is not given to persons 7 years of age or older. Adolescents and adults ages 10-64 can receive booster shots called Tdap to enhance their immunity against Pertussis.
IS THE PERTUSSIS VACCINE SAFE?
Yes, it is safe for most people. Some children will get a slight fever and be cranky for a day or two after getting a DTaP shot. Some children will have a sore spot and some swelling or redness where the shot was given. Only rarely will a child have a more serious side effect, such as prolonged crying, convulsions or high fever. DTaP (diphtheria, tetanus and acellular pertussis vaccine) is less likely to cause side effects than the DTP ( diphtheria, tetanus and whole-cell pertussis vaccine) and is now used routinely in the United States. However, following the 4th and 5th DTaP doses there are more local reactions (pain, redness, or swelling at the site of injection) compared with the first 3 DTaP doses.
Though there is a very slight risk of problems caused by the vaccine, pertussis or whooping cough is extremely serious. It can last for weeks or months and lead to serious complications. Pertussis causes about 10-20 deaths each year in the United States. That is why experts recommend that all infants and children be given a full series of DTaP vaccine unless there is a medical reason not to receive the vaccine.
For more information: Speak with your doctor or nurse; visit Centers for Disease Control website at www.cdc.gov/.