Murfreesboro—An outbreak of pertussis (whooping cough) has been identified in Murfreesboro. The Health Department confirms today that several school students have positive cultures and more than 50 people have signs and symptoms consistent with the illness. Health Department colleagues are working closely with local doctors, the schools and community leaders to stem the outbreak.

Keys in controlling the outbreak are to ensure vaccination of children and to treat cases and their close contacts with appropriate antibiotics. Children routinely should receive four doses of a vaccine (DTaP) by 15 months of age and an additional dose of DTaP before they start school. As a control measure, the Health Department has recommended accelerating the vaccine schedule for infants, starting at six weeks of age instead of two months, and with a shorter interval between the next three doses (this is for children in Pike County only).

Those diagnosed with pertussis should stay home from school or work until after the fifth day of antibiotic treatment to prevent the spread of the disease. Close contacts need preventive treatment but may continue routine activities if they have no symptoms.

Whooping cough can be a very serious illness, particularly for infants less than one year of age. The disease is spread through droplets and coughing. The illness begins with symptoms similar to a common cold. Young children usually later develop coughing "fits," usually 15 to 20 times a day. The high-pitched "whoop" for which the illness is named occurs when they try to catch their breath between coughs. Vomiting may follow a coughing fit. Adults usually have milder symptoms. Those with coughing symptoms or who think they may have been exposed should be evaluated by their doctor.

The protection from disease provided by the vaccine decreases over time, leaving adolescents and adults vulnerable to infection. Throughout the U.S., more pertussis in teens and adults is being recognized and small outbreaks are not unusual.

Physicians in surrounding communities have been alerted to watch for increase coughing illnesses in their patients. Dr. David Bourne, NW Regional Medical Leader of the Health Department, said, "The timing of this outbreak is unfortunate, coming as it does near the start of flu season. It may be difficult to tell when patients have whooping cough and when they heave a common cold or the flu. We want to thank the entire community of Murfreesboro for their excellent cooperation and hope we can prevent the spread to surrounding towns."

PERTUSSIS FACT SHEET

What is pertussis?

Pertussis, or whooping cough, is a highly contagious disease involving the respiratory tract (nose, throat, and chest). It is caused by a bacteria that is found in the nose and throat of an infected person. 

Who gets pertussis? 

Pertussis can occur at any age. Adults and adolescents have recently been recognized as a major source of pertussis, accounting for as many as 25% of reported cases. The rest of the cases are in children less than 5 years of age. Approximately 35% of reported cases currently occur in infants younger than 6 months. 

How is pertussis spread? 

Pertussis is primarily spread by direct contact with discharges from the nose and throat of infected individuals. Frequently, older siblings who may be harboring the bacteria in their nose and throat can bring the disease home and infect an infant in the household. 

What are the symptoms of pertussis? 

Pertussis begins as a mild upper respiratory infection. Initially, symptoms resemble those of a common cold, including sneezing, runny nose, low-grade fever and mild cough. Within two weeks, the cough becomes more severe and is characterized by episodes of numerous rapid coughs followed by a crowing or high-pitched whoop. A thick, clear mucous may be discharged. These episodes may recur for one to two months, and are more frequent at night. 

How soon after infection do symptoms appear? 

The incubation period is 6-20 days, usually 7-10 days. 

When and for how long is a person able to spread pertussis? 

A person can transmit pertussis from seven days following exposure to three weeks after the onset of coughing episodes. The period of communicability is reduced to 5 days when antibiotic therapy is begun. 

What can be done to prevent the spread of pertussis? 

The single most effective control measure is maintaining the highest possible level of immunization in the community. Close contacts younger than 7 years who are unimmunized or who have received fewer than four doses of pertussis vaccine should have pertussis immunization initiated or continued, according to the recommended schedule. Treatment with erythromycin can shorten the contagious period of cases as well as protect close contacts. Any persons who have been in contact with an infected individual should see their physician if they develop respiratory symptoms for 14 days after the last contact with the infected individual.  

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