Health District reports increase in pertussis cases;
Reminds community vaccine is available
LAS VEGAS – The Southern Nevada Health District is reporting 22 cases of pertussis since January. Seven of these cases have occurred in children less than one year of age. The health district reminds parents, health care providers and child care providers to receive the vaccine. For information, contact the immunization clinic, (702) 759-0850 or visit the health district’s website, www.SNHD.info.
The Southern Nevada Health District is advising parents and caregivers who bring their children to the health district to update their pertussis vaccinations, including adults who care for or live with infants. In addition, a technical bulletin as been distributed to physicians and health care providers to consider pertussis and test for it when patients appear symptomatic.
Pertussis is a very contagious, bacterial respiratory disease. Although it might be a mild disease in older children and adults, in younger children and infants it can result in hospitalization due to complications including severe respiratory distress and inflammation of the brain. In rare cases, pertussis can cause death, especially in children less than one year of age. In California’s 2010 outbreak, five infants, all under three months of age, died. Adherence to the recommended immunization schedule for children is the most important way to provide protection. Infants must receive their first dose of pertussis vaccine at two months, and again at four months, six months and between 15 and 18 months. A fifth dose of DTaP is required prior to school entry.
Pertussis, or “whooping cough” is a reportable illness and the health district receives reports of cases each year. By July, the health district has received more case reports than has been reported by this time in previous years. The epidemiological investigation has not linked patients who are not living in the same household directly to one another, which could mean the illness is circulating in the community and is under-reported. The health district is advising people in the community to receive the vaccine as it is the most effective way to prevent the illness. The health district reported 20 cases in 2011. Nationwide, there has been a 70 percent increase in the number of cases. Currently, Washington State is experiencing a pertussis outbreak with more than 2,000 cases reported in 2012.
Children and adults who are partially protected by the vaccine can have a milder illness than infants and very young children, however, they can still transmit the disease to others, including infants too young to be immunized. Infants younger than six months might have a cough that does not include the “whooping” sound. Prompt use of antibiotics in a household is helpful in limiting other cases.
The disease can occur at any age, but it is most commonly reported in children during the first year of life. Infants and young children usually get the disease from an older sibling or from an adult who has a mild case of the illness. The bacteria are spread in the air by droplets produced during coughing or sneezing. Once a person is exposed, it takes seven to 10 days before the first symptoms appear.
Symptoms of pertussis usually occur in stages, with the initial stage appearing like a cold with a runny nose, sneezing, low-grade fever and a cough, which lasts one to two weeks before it worsens. The second stage of the disease includes uncontrolled coughing spells followed by the “whooping” sound a person makes when he breathes in. During these severe coughing spells, vomiting may occur, or the person’s lips or face might look blue due to a lack of oxygen. The second stage can last four to six weeks, if untreated.
Children attending school in Clark County must be immunized against pertussis before they can attend kindergarten and prior to entering the 7th grade. Older children and adults, including adults over the age of 65, should receive pertussis containing tetanus vaccine (Tdap) in place of their next tetanus shot. Adults who have not received a Tdap dose should receive a single dose. It is especially important for children older than age 11 and adults who live with or care for infants to be vaccinated. The Tdap vaccine prevents the illness in 70 percent to 90 percent of those who receive it. Because immunity begins to wane approximately five years after the last dose of vaccine, adolescents and adults are left with little or no protection against the disease. There is no minimum waiting time between receiving a regular tetanus booster (Td) and getting the Tdap vaccination. All older children and adults should receive one dose of Tdap if they have not been vaccinated with Tdap. Those who have frequent contact with infants should be vaccinated with Tdap now rather than waiting until their next tetanus shot is due. It is recommended that pregnant women be vaccinated with Tdap after reaching 20 weeks gestation.