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Cases On The Rise: Pertusis a Concern

By Jeanne Sager
SULLIVAN COUNTY — November 17, 2006 — The numbers are piling up. They’re calling it an outbreak.
Although every child in New York State is required to be vaccinated against pertussis, Sullivan County has seen a sudden spike in reported cases this year.
Carol Ryan, head of Sullivan County Public Health Nursing, said there are 23 confirmed cases already this year, with six more under investigation.
Complicating the matter?
Pertussis in adults is rarely diagnosed – because the disease more commonly known as “whooping cough,” presents itself without the characteristic “whoop.”
So adults exposed to children with the disease can be carrying it on – and no one would be the wiser.
Ryan said Public Health has already swung into action.
In the Livingston Manor and Roscoe areas, where the majority of the cases have been reported, nurses have already held one vaccination clinic.
Sixty students at the Manor school received the shot.
Another clinic is being set up for students at the neighboring Roscoe school.
This is a rarity, Ryan said; her nurses give vaccination clinics all year round, but never at a particular school.
They call it “secondary prevention.”
“The less people you have that are undervaccinated, the less risk you have,” she said.
But 29 people doesn’t sound like many, right?
Compare that to 2002 – 0 cases were reported in Sullivan County that year.
Or 2005, when just five cases made the report.
According to the Centers for Disease Control (CDC) in Atlanta, Ga., which tracks communicable diseases, there are only 5,000 to 7,000 cases reported annually in the entire country.
The CDC hasn’t reported an epidemic since 1996, but says incidence is on the rise.
And along with it, there are complications.
“In a child [with pertussis], you pretty much know something is drastically wrong,” Ryan said.
Children will cough severely, a cough that’s marked by the distinctive “whooping” sound as the child attempts to catch his or her breath.
Ryan said a child desperate for air can turn blue, and the violent coughing can cause them to vomit.
Once airborne, pertussis is highly contagious.
“The violent cough makes those organisms go far,” Ryan explained.
Infants are at the highest risk, according to the CDC, with bacterial pneumonia setting in that can claim the baby’s life.
Although the CDC numbers show just 13 children died from pertussis in 2003, more than 50 percent of pertussis-related deaths are in infants.
Ryan said the Sullivan cases reported in recent months are mostly in middle and high school students.
Most of those students, she said, seem to have been “underimmunized” as babies.
New York State recommends children received a DtaP vaccine, which inoculates a child against diphtheria, tetanus and pertussis at 2 months, 4 months, 6 months, between 15 and 18 months and again before the child enters school.
But Ryan said it’s up to parents to ensure their children get those vaccines in a timely manner – doctors’ appointments should be kept according to the immunization schedule, and doses cannot be skipped.
“It’s good to know what your child got and what your child needs to get,” she noted.
She recommends picking up a New York State Health Department Immunization Schedule, available at Public Health Nursing, at the CDC Web-site or at many pediatricians’ offices.
“See what’s due and how they’re doing,” she said. “Pertussis is not the only thing kids can catch – there are so many diseases out there.”
Ryan said awareness is also key.
Children who have yet to be vaccinated should not be exposed to infected people, and exposure can be dangerous to the elderly and others who have compromised immune systems.
Scientists don’t yet know how long the vaccine actually lasts, so even adults exposed to individuals with pertussis should contact their healthcare provider.
“The thing with pertussis is, [the vaccine] is not going to give you a lifelong protection,” Ryan explained.
Adults who have been coughing for more than two weeks should seek medical attention – a simple test can be done in a healthcare provider’s office to determine whether they have pertussis.
Although anyone suffering from pertussis is contagious – for as long as three weeks after they begin coughing – antibiotic therapy has been shown to significantly reduce that risk.
Adults and older children can also be immunized, although they will be given a Tdap vaccine rather than the DtaP administered to children younger than 7.

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