Several counties in North Carolina have seen increases in the number of whooping cough cases, also known as Pertussis, over the past few months. Sampson County has now joined those ranks, with confirmed cases that have been steadily increasing over the past few weeks to a current total of nine.
The Sampson County Health Department is working closely with local medical providers to identify cases and provide treatment for the cases and their contacts.
Pertussis (whooping cough) can cause serious illness in infants, children and adults. The disease usually starts with cold-like symptoms as maybe a mild cough or fever. After 1 to 2 weeks, severe coughing can begin. Unlike the common cold, Pertussis can become a series of coughing fits that continues for weeks.
Pertussis can cause violent and rapid coughing, over and over, until the air is gone from the lungs and you are forced to inhale with a loud “whooping” sound. This extreme coughing can cause you to throw up and be very tired. The “whoop” is often not there and the infection is generally milder (less severe) in teens and adults, especially those who have been vaccinated.
Because Pertussis in its early stages appears to be nothing more than the common cold, it is often not suspected or diagnosed until the more severe symptoms appear. Infected people are most contagious up to about 2 weeks after the cough begins. Antibiotics can shorten the amount of time someone is contagious. Early symptoms can last for 1 to 2 weeks and usually include:
* Runny nose
* Low-grade fever (generally minimal throughout the course of the disease)
* Mild, occasional cough
* Apnea — a pause in breathing (particularly in infants)
As the disease progresses, the traditional symptoms of Pertussis appear and include:
* Paroxysms (fits) of many, rapid coughs followed by a high-pitched “whoop”
* Vomiting (throwing up), usually during or immediately after a coughing fit
* Exhaustion (very tired) after coughing fits
The coughing fits can go on for up to 10 weeks or more. Although you are often exhausted after a coughing fit, you usually appear fairly well in-between. Coughing fits generally become more common and severe as the illness continues, and can occur more often at night. The illness can be milder (less severe) and the typical “whoop” absent in children, teens, and adults who have been vaccinated with a Pertussis vaccine. Recovery from Pertussis can happen slowly with the cough becoming less severe and less frequent over time. However, coughing fits can last or return with other respiratory infections for many months after Pertussis started.
Pertussis (whooping cough) can cause serious and sometimes life-threatening complications in infants and young children, especially those who are not fully vaccinated. This age group is at greatest risk for getting Pertussis and then having severe complications from it, including death. Infants with Pertussis frequently have atypical symptoms. The cough can be minimal or absent all together. Apnea is a commonly reported symptom, and sometimes the only symptom. Apnea is a slowing or stopping in the child’s breathing pattern. Approximately half of infants younger than 1 year old who get Pertussis are hospitalized. Complications for those infants who are hospitalized with Pertussis include:
• 1 in 4 (23 percent) get pneumonia (lung infection)
• 1 or 2 in 100 (1.6 percent) will have convulsions (violent, uncontrolled shaking)
• Two thirds (67 percent) will have apnea (slowed or stopped breathing)
• 1 in 300 (0.4 percent) will have encephalopathy (disease of the brain)
• 1 or 2 in 100 (1.6 percent) will die
There are two strategies to protect infants until they’re old enough to receive vaccines and build their immunity against this disease. First, vaccinate pregnant women, preferably at 27 through 36 weeks of each pregnancy. By getting Tdap during pregnancy, mothers build antibodies that are transferred to the newborn, likely providing protection against Pertussis in early life, before the baby can start getting DTap vaccines at 2 months old. Tdap also helps protect mothers during delivery, making them less likely to transmit Pertussis to their infants.
Second, make sure everyone that has routine contact with a baby is immunized. This includes parents, siblings, grandparents (including those 65 years and older), other family members, babysitters, caregivers, etc. They should be up-to-date with the age-appropriate vaccine (DTap or Tdap) at least two weeks before coming into close contact with the infant.
These two strategies are very important in reducing Pertussis in infants, since health data have shown that, when the source of Pertussis could be identified, mothers were responsible for 30-40 percent of infant infections and household/close contact members were responsible for about 80 percent of infections.
Teens and adults, especially those with compromised immune systems, can also get complications from Pertussis. They are usually less serious in this older age group, especially in those who have been vaccinated with a Pertussis vaccine. Complications can include pneumonia, and rib fracture from coughing, loss of consciousness, female urinary incontinence, hernias, angina, and weight loss.
Getting sick with Pertussis or getting Pertussis vaccines doesn’t provide lifelong protection, which means you can still get Pertussis and pass it onto infants. Your immune system’s response naturally lowers as time passes; however the symptoms are usually not as severe. For those who have been vaccinated or had the disease:
* In most cases, the cough won’t last as many days
* Coughing fits, whooping, and vomiting after coughing fits occur less often
* Fewer children have apnea (long pause in breathing) or cyanosis (blue/purplish skin coloration due to lack of oxygen)
* Vomiting is less
The Sampson County Health Department is constantly monitoring the situation and contacting providers and residents as needed. To help control the spread of Pertussis, the Health Department strongly encourages the following:
* Contact your medical provider if you suspect you or someone in your home may have Pertussis.
* Make sure your children’s immunizations are up to date, especially infants, toddlers and young children.
* If you are pregnant, get your Tdap Vaccine during your 27th – 36th week of pregnancy to help provide antibodies that will protect your new baby.
* If you are in frequent contact with an infant, young child or a person with a compromised immune system, get a Tdap vaccination. This is especially true of parents, siblings, grandparents, other family members and caregivers of newborns and young infants.
* If you are an adult and have never had a Tdap vaccine booster, you need at least one dose.
* If you have a compromised immune system, talk with your medical provider about the importance of immunizations, especially the Tdap vaccine.
For more information about Pertussis, please contact the Sampson County Health Department at 910-592-1131, ext. 4960 or 4001.