Montana has seen an increase in pertussis cases in the past few years.
Two years ago, California reported 9,143 cases of pertussis (including 10 infant deaths). In 2010, the U.S. reported 27,550 cases of pertussis.
Looking back at the history of pertussis, outbreaks were first described as early as the 16th century. The Centers for Disease Control and Prevention state that in the 20th century, pertussis was one of the most common childhood diseases. In the United States, it was a major cause of childhood mortality. After a vaccine for pertussis was developed, incidence of the disease dropped more than 80 percent.
However, since the 1980s, the number of reported cases has increased. A concern is that many more cases go undiagnosed and unreported.
Pertussis is an acute bacterial infection of the respiratory tract, caused by Bordetella pertussis. The disease can range in severity, from mild to life-threatening. It is transmitted by direct contact with airborne droplets from respiratory mucous membranes of infected people.
Pertussis is divided into three stages:
1. Catarrhal: Usually seven to 10 days and is characterized by runny nose, low-grade fever and mild, occasional cough that gradually becomes more severe.
2. Paroxysmal: Usually one to six weeks, but may persist for up to 10 weeks, and is characterized by numerous rapid coughs, long inspiratory effort accompanied by a high-pitched “whoop” at the end, cyanosis, vomiting and exhaustion.
3. Convalescent: Usually lasts seven to 10 days and is characterized by gradual recovery.
Pertussis is highly communicable in the early catarrhal stage and at the beginning of the paroxysmal cough stage. Testing for pertussis is done via a nasopharynx swab. Treatment for pertussis is primarily supportive, although antibiotics can be of value by limiting the infectiousness of the disease.
The most effective way to prevent pertussis is through vaccination. Children 6 years of age and younger getthe DTaP vaccine. DTaP is a safer version of the older vaccine called DTP. DTP is no longer used in the United States. Children should get five doses of DTaP vaccine by age 6 .
Tdap is recommended at age 11 or 12. Tdap vaccine, licensed in 2005, is the first vaccine for ages 7 and older that protects against tetanus, diphtheria and pertussis. This dose can be given as early as age 7 for children missing one or more childhood doses of DTaP.
A Td booster is recommended every 10 years. Adults who did not receive Tdap between ages 7 and 18 should get a dose of Tdap in place of the Td booster. Tdap is not currently licensed for multiple administrations. After receipt of Tdap, individuals should receive routine Td booster immunization against tetanus and diphtheria.
For more information, contact your health care professional or the Centers for Disease Control and Prevention.
Pamela Goldberg is the infection control coordinator at Community Medical Center.