By Dr. Jean Hudson Published: 2:00 AM – 12/21/11

Thanks to vaccinations, pertussis — commonly known as whooping cough — once seemed a thing of the past, seldom heard about in our schools. Today, unfortunately, notes sent home by the school nurse are beginning to tell a different story: Whooping cough is on the rise.

Experts are not entirely sure why there has been a resurgence in this highly contagious bacterial infection. Some believe current infant vaccinations may no longer be enough, and immunity begins to decline during the adolescent years. In fact, the government is now considering a booster shot to strengthen immunity to this sometimes deadly disease. so how do you know if what you’re dealing with is actually whooping cough? to hear the classic cough and “whoop,” go to healthyorange.com and follow the whooping cough links on the front page. It’s distressing. Worse, it can be fatal, particularly in the first year of life.

That’s why hospitals and obstetricians are beginning to offer not only flu shots but also Tdap boosters (tetanus, diphtheria and acellular pertussis) to new parents, grandparents and other close contacts of newborns to prevent transmission of the disease.

The problem is that older children and adults usually don’t “whoop” when struggling for air, which can make recognizing the disease difficult. What they may experience is paroxysmal coughing, or a severe coughing attack, that can result in vomiting.

Of course, at this time of year the persistent cough can easily be confused with other cough illnesses, often caused by viruses. Pertussis (whooping cough), however, is a bacterial infection that can be treated with antibiotics — if diagnosed early enough.

While deaths from whooping cough have recently risen, cases have increased, too, with 27,550 reported nationwide in 2010. In Orange County this year, we have seen 21 cases, 14 of those since October. Doctors in the county (and state) have been alerted to “think pertussis” when seeing patients with chronic cough.

So protect yourself and your family — keep your shots up-to-date, stay home if you’re sick, don’t ignore persistent symptoms, and keep that handwashing going.

P.S. You’ve had your flu shot, right?

Dr. Jean Hudson, MD, MPH, is the Orange County Health Commissioner.

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A seventh-grader at Oblock Junior High School has been cleared to come back to class after being treated for whooping cough.

Principal Joseph Fishell said the student, who was not identified, was diagnosed with the highly contagious disease spread through the air and also known as pertussis and placed on antibiotics for five days.

The male student late last week was cleared to come back to school.

“The nurse did an outstanding job,” Fishell said.

The principal said no other cases of whooping cough have been identified at Oblock.

Pertussis begins with cold symptoms and a cough that becomes worse over a one to two week period, according to the Allegheny County Health Department.

Physicians treat about three-dozen cases of whooping cough in Allegheny County each year, said Bruce Dixon the Health Department. The bacterial infection is treated easily with antibiotics, he said.  

Children are required to receive a Tdap vaccine to attend school. The vaccine prevents tetanus, diphtheria and pertussis to attend school.

Infants and young children typically receive the initial vaccine. Due to the increase of cases of whooping cough, the vaccine is now recommended for 11 to 12 year-olds or as a catch-up at age 15 if not received earlier, according to a letter sent to Oblock parents from school nurse Tina Jagodzinski.

Jagodzinski in the letter outlined the symptoms of whooping cough:

Persistent coughing that may progress to severe coughing and could cause vomiting, shortness of breath or difficulty breathing and;

Whooping (high-pitched crowing sound) when breathing in after a period of coughing;

Adults also are advised to get vaccinated against pertussis, according to Jagodzinski's letter.

Stopping the spread might be up to adults and adolescents who now need booster shots to bolster their immunity against the resurgent disease, according to officials of the Pennsylvania Academy of Family Physicians.

“They need to protect themselves because of the waning immunity of their own vaccinations,” said Gaspere Geraci, chair of the Education Commission of the Pennsylvania Academy of Family Physicians. “But this disease is even tougher if they pass it on to those infants and small children they might be around at work, home or in the community.”

Katherine Neely, program director of Forbes Family Residency at Forbes Regional Hospital in Monroeville, agreed. she said the vaccine adults received as children eventually wears off.

“It's babies who die of whooping cough, and we solved that a long time ago, but there continued to be a few of them,” she said. “We finally realized a while back that the reason it stays around is because adults get it, too. as long as we all continue to get it, the disease will continue.

“Kids who haven't gotten their shots yet can get it from adults, people with low immune systems can get it, so one of the big pushes we're making is to get adults to get vaccinated.”

Though the vaccine previously wasn't recommended for adults because of severe side effects, the Tdap booster that was introduced in 2006 is safe for adults, Neely said. it hasn't been determined how long it stays in effect.

“Right now, they're saying to give everyone just one,” she said. “They may later require that we get it every 10 to 20 years, but we won't know until we follow ourselves. We're the guinea pigs for how long it lasts.”