April
18, 2005
Little Rock
- Down to barely 1,000 cases in 1976, pertussis (whooping cough) rose steadily rose in the 1980s and 1990s in America. Then it jumped, first to 9,771 in 2002 and then to 11,647 in 2003. Preliminary numbers for last year showed the case load almost reached 19,000. This year, even though it’s not at peak season yet, whooping cough cases are nearly double last year’s level of 37,000 cases. In the first 12 weeks of 2005, there have been 3,445 whooping cough cases — more than in 1981 and 1982 combined.
Scientists believe the disease is infecting adolescents whose childhood vaccinations are wearing off. This spring, federal health officials are expected to approve and recommend a new booster shot for young teens. “Pertussis is a substantial public health problem in the U.S.,” said Dr. Karen Broder, a Centers for Disease Control and Prevention medical epidemiologist specializing in infectious childhood diseases.
Arkansas’ figures for pertussis mirror the national levels. Our last outbreak was in 2001 (859 cases) and 2002 (520cases) in which we led the nation in cases. In 2004, Arkansas had 90 cases reported
for the entire year. Currently, we have 50 cases reported, with many more being investigated.
Keys in controlling the outbreaks are to ensure vaccination of children and to treat cases and their close contacts with appropriate antibiotics. Children routinely should receive four doses of DtaP by 15 to 18 months and an additional booster dose at four to six years of age. 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 and toddlers. 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 children try to catch their breath between coughs. Vomiting may follow a coughing fit. Adults usually have milder symptoms. Those with severe coughing symptoms for more than two weeks or those who think they may have been exposed should be evaluated by their doctor.
DTaP vaccine is not given to individuals over the age of six and disease protection levels from the vaccine decreases over time, leaving adolescents and adults vulnerable to infection. Throughout the United States, more pertussis in teens and adults is being recognized and small outbreaks are not unusual.
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