KDHE Reminds Kansans to Get Vaccinated for Pertussis as Cases Increase

The Kansas Department of Health and Environment (KDHE) is reporting a significant increase in the number of pertussis (whooping cough) cases as compared to previous years. Statewide there are 141 confirmed cases and 166 probable cases. Fifty-four counties are experiencing at least one case of pertussis. Five counties comprise 51 percent of the cases and they are Douglas, Johnson, Kiowa, Reno, and Sedgwick.

Since Jan. 1, about 17 percent of all confirmed and probable cases have been in infants less than a year, while 22 percent have been in adults older than 45 years of age.

At this time last year (2004), Kansas also experienced an increase in cases with 46 lab confirmed cases. In all of 2004, there were 98 confirmed cases. In 2003, there were 23 confirmed cases, and in 2002, there were a total of 38 confirmed cases. From 1999 - 2001, the three-year median was 18 confirmed cases.

"It is critical that parents get their children vaccinated for pertussis to prevent this difficult and highly contagious illness, which can be easily spread to other family members and community members," said Howard Rodenberg, M.D., M.P.H., Director of KDHE's Division of Health.

"Fortunately, a new vaccine is now approved for use, which can be given as a booster to older children and adults," Rodenberg added. "This should help reduce the number of cases in children whose vaccine would otherwise have worn off and become ineffective."

Earlier, this year the Advisory Committee on Immunization Practices (ACIP) recommended that adolescents aged 11-18 years receive one of the two newly licensed Tdap vaccines (Tetanus and Diphtheria and Pertussis) in place of the currently recommended Td (Tetanus and Diphteria) booster. These vaccines are the first pertussis antigen-containing vaccines to be licensed in the United States for use in adolescents or adults and should help reduce the increasing burden of pertussis in adolescents.

The ACIP also recommended that adolescents 13-18 who missed the 11-12 year dose of Td receive Tdap. Adolescents 11-18 who have already received Td are encouraged to receive a dose of Tdap to protect against pertussis. Additional information on the Tdap vaccine and pertussis may be found at the following Web site: http://www.cdc.gov/nip/vaccine/tdap/default.htm.

Transmission and diagnosis of pertussis (whooping cough):

Pertussis is a highly contagious respiratory infection commonly referred to as whooping cough. It is a potentially fatal childhood disease that is preventable with vaccination. The disease is named after the "whoop" sound children and adults often make when they try to inhale during or after a severe coughing spell.

People can get infected with pertussis by inhaling contaminated droplets from an infected person's cough or sneeze or by sharing drinking receptacles or eating utensils. A person with pertussis becomes contagious in the early stages of infection. During this period, the person usually just has a runny nose. They are still quite contagious the first two weeks after onset of the cough (approximately 21 days total).

Mild cases of pertussis are difficult to diagnose because they resemble a cold, according to the Centers for Disease Control and Prevention (CDC). However, mild cases can be passed on to young children and can produce severe illness in the child.

Symptoms of pertussis (whooping cough):

Symptoms of pertussis appear as a cold or flu-like including a runny nose, sneezing, fever, and a mild cough. Symptoms can last up to two weeks and are followed by increasingly severe coughing spells. Fever, if present, is usually mild. Symptoms appear between six to 21 days (average 7-10) after exposure to the bacteria.

During a classic coughing episode, the signature "whoop" is heard when the patient struggles to breath. Cough usually produces a thick mucus. Vomiting may occur after a coughing episode and the lips and nails may turn blue due to lack of oxygen. The patient is left exhausted after the coughing spell.

Prevention and treatment of pertussis:

If you, or a member of your family, is exhibiting symptoms, including cough for two weeks or longer, without other explanation, please contact your physician. There are medications to treat the infection and relieve the symptoms. The CDC urges individuals that suspect they have pertussis to limit contact with unvaccinated children and see a physician as soon as possible.

The single most effective control measure is immunization of the most vulnerable population against pertussis. Immunization is recommended at ages 2, 4, 6, and 12 months with a booster at kindergarten entry.

Young infants are at highest risk for pertussis-related complications, including seizures, encephalitis (swelling of the brain), severe ear infection, anorexia (severe loss of appetite) and dehydration. Pneumonia is the most common complication and cause of infantile pertussis-related deaths.

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