Increase in whooping cough cases prompts health alert

by Symptom Advice on February 1, 2011

HEALTH

Since 2007, Montgomery County has seen numbers more than quadruple to 140 cases last year.

Montgomery County saw a dramatic rise in whooping cough cases last year, a national trend that prompted the U.S. Centers for Disease Control and Prevention to issue a public health alert.

Whooping cough, also known as pertussis, is a highly contagious respiratory illness characterized by a persistent loud cough that makes it hard to breathe. The disease most commonly affects infants and young children and can be deadly, especially in babies less than a year old.

Nationally, public health officials have been alarmed by recent outbreaks of the disease, particularly in California where it’s considered a statewide epidemic.

Since the 1980s, there’s been an increase nationally in the number of whooping cough cases, especially among children between 10 and 19 years old and babies younger than 6 months of age. in 2009, nearly 17,000 cases were reported, including 14 deaths.

Preliminary data for Pennsylvania shows whooping cough cases jumped from 557 to 899 between 2009 and last year – a 61 percent increase, according to the state Department of Health.

But Montgomery County has seen numbers more than quadruple since 2007, to 140 cases last year including one fatality involving an infant 2 months old, according to preliminary county health department numbers. That is the highest number since 2006 when 111 cases were reported.

Forty percent of the cases last year involved a single, under-vaccinated school community, health department spokeswoman Harriet Morton said. she did not identify the school where the outbreak occurred.

In Bucks County, whooping cough cases are stable, ranging from a low of 14 in 2007 to a high of 26 last year, according to county health department Director Dr. David Damsker.

U.S. children are routinely vaccinated against the disease, but the vaccines are not 100-percent effective. Also vaccine protection fades over time, which means teens and adults become susceptible to the infection.

"It’s something you see in adults more than we used to," said Dr. Richard Tepper, an infectious disease specialist at Holy Redeemer Medical Center in Abington, which is hosting a free vaccine safety seminar on Tuesday night featuring Dr. Paul Offitt, the nation’s most outspoken advocate for childhood immunizations.

The increase in adult whooping cough cases is one reason why the CDC last week issued a new recommendation that adults over age 65 get a booster of the Tdap vaccine, which also protects against tetanus and diphtheria.

The Tdap vaccine for adults has been available since 2005, Tepper said. Holy Redeemer offers it free to new moms after they deliver to protect them and their infant.

Montgomery County health officials have not identified what’s behind the increase in whooping cough cases, but Morton cited as likely sources decreasing immunity among teens and adults and more unvaccinated children, as well as a new, more sensitive test to confirm the disease.

She added the county began offering Tdap boosters at its 2010-11 flu clinics, and administered 757 doses of the vaccine. The county also now will offer boosters to adults 65 and older who had not previously been vaccinated.

Holy Redeemer’s Tepper suspects the increase is more cyclical than anything else. Whooping cough outbreaks tend to appear every five years.

In adults with waning immunity protection, the symptoms can appear as nothing more than a persistent bad cough, so they’re more likely to spread it to children, Tepper said.

If more adults get the booster vaccine, Tepper suspects the number of cases will drop.

Jo Ciavaglia can be reached at 215-949-4181 or . for more health and fitness information, visit Jo’s blog, Working my Butt off, at phillyBurbs.com/opinions/blogs/ courier_blogs/jo_ciavaglia.html. Follow Jo on Twitter at twitter.com/jociavaglia.

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IF YOU GO

Holy Redeemer Hospital will be holding a free community forum on vaccination safety on Feb. 1 from 7 to 8 p.m. The event features Dr. Paul Offitt, co-inventor of the rotavirus vaccine, chief of infectious diseases at The Children’s Hospital of Philadelphia and the nation’s most outspoken advocate for childhood immunizations.

He will discuss the importance and controversy surrounding vaccines for infants, children and adults.

The event will take place in the Holy Redeemer Hospital Auditorium, first floor. The hospital is located at 1648 Huntingdon Pike, Abington.

To register call 1-800-818-4747 or register online at holyredeemer.com. Free parking is available in the hospital garage.

ALL ABOUT WHOOPING COUGH

Pertussis, better known as whooping cough is a highly contagious disease caused by a type of bacteria called Bordetella pertussis

. Among vaccine-preventable diseases, pertussis is one of the most commonly occurring ones in the United States.

Teens and adults need to be revaccinated, even if they were completely vaccinated as children. Pertussis vaccines are not 100-percent effective. If the disease is circulating in the community, there is a chance that a fully vaccinated person can catch it

The disease starts like the common cold, with runny nose or congestion, sneezing, and maybe mild cough or fever. but after one or two weeks, severe coughing can begin. unlike the common cold, pertussis can become a series of coughing fits that continues for weeks. Pertussis can cause violent and rapid coughing, over and over, until the air is gone from the lungs and you are forced to inhale with a loud "whooping" sound. in infants, the cough can be minimal or not even there. Infants may have a symptom known as "apnea." Apnea is a pause in the child’s breathing pattern.

Pertussis is most severe for babies; more than half of infants younger than 1 year of age who get the disease must be hospitalized. About 1 in 5 infants with pertussis get pneumonia and about 1 in 100 will have convulsions. in rare cases it can be deadly, especially in infants

People with pertussis usually spread the disease by coughing or sneezing while in close contact with others, who then breathe in the pertussis bacteria. many infants who get pertussis are infected by parents, older siblings, or other caregivers who might not even know they have the disease.

Babies are most vulnerable before they can have their first vaccine against pertussis at two months of age. Children are not fully protected until they have received the complete course of vaccination by age 7.

The CDC recommends a single pertussis booster for any adult aged 19 to 64 who is in close contact with a baby, particularly parents, grandparents, babysitters and healthcare workers who work with infants.

Adults who didn’t get the tetanus, diphtheria, and pertussis (Tdap) booster vaccine as a pre-teen or teen should get one dose of Tdap instead of their next regular tetanus and diphtheria (Td) booster vaccine. Most pregnant women who were not previously vaccinated with Tdap should get one dose of Tdap postpartum before leaving the hospital or birthing center. The CDC also recommends the Tdap booster vaccine to protect adolescents between the ages of 11 and 18.

Source: U.S. Centers for Disease Control and Prevention

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