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December 14, 2012

Pertussis Cases on the Rise

Cases of pertussis continue to climb in Wisconsin, but families can take measures to protect themselves and others. Pertussis, also known as whooping cough, is a highly contagious respiratory tract infection.

Cases of pertussis continue to climb in Wisconsin, but families can take measures to protect themselves and others. Pertussis, also known as whooping cough, is a highly contagious respiratory tract infection. One of its main symptoms is a severe hacking cough followed by a high-pitched intake of breath that sounds like “whoop.”

“It can cause a severe prolonged illness in children and adults, but especially in infants,” said Sarah Haroldson, MD, family physician at ThedaCare Physicians-New London. “It can be fatal in infants.”

According to the Centers for Disease Control, during 2012, increased pertussis cases or outbreaks have been reported in a majority of states. As of Nov. 21, 49 states and Washington, D.C. have reported increases in disease compared with the same time period in 2011. High rates of pertussis are being reported in Wisconsin. As of Oct. 31, 5,163 cases have been reported. During 2011, 1,192 probable and confirmed cases were reported.

Whooping cough is thought to be on the rise for two main reasons. The whooping cough vaccine you receive as a child eventually wears off. “Even having whooping cough does not confer long-lasting immunity,” said Russ Butkiewicz MD, family physician, ThedaCare Physicians-Waupaca.. This leaves most teenagers and adults susceptible to the infection during an outbreak.

Also, children aren’t fully immune to whooping cough until they’ve received at least three shots, leaving those 6 months and younger at greatest risk of contracting the infection.

Dr. Haroldson said the best thing families can do is protect themselves with a pertussis vaccination, which is often given in combination with vaccines against two other serious diseases — diphtheria and tetanus. “Our hospitals are recommending the boosters to the entire the family,” said Dr. Haroldson. The vaccine is available to families of newborns in the birth center.

Pertussis can start with regular cold like symptoms. However, many people don’t develop the whoop. A hacking cough may be the only symptom an adolescent or adult has whooping cough.

“Symptoms in adults can sometimes be severe and the cough can last 30 days or more,” said Dr. Butkiewicz.

If whooping cough is suspected, the patient needs to be tested, treated with antibiotics and isolated. Testing may include a nasal swab. The patient may also be tested with blood tests and chest X-ray to rule our other illnesses, but these don’t necessarily help make the diagnoses of pertussis. It can take 3-5 days for the test results to come in.

“The antibiotic doesn’t make the symptoms go away sooner; it just keeps it from spreading,” said Dr. Haroldson.

Infants and toddlers are at greatest risk of complications from whooping cough and would require hospitalization. Some complications can be life-threatening for infants less than 6 months old.

Unfortunately, not much is available to relieve the cough. Over-the-counter cough medicines, for instance, have little effect on whooping cough and are discouraged.

Doctors recommend plenty of rest and fluids; preventing the spread by covering coughs; eating smaller meals to prevent vomiting during coughing; and vaporizing the room, or taking a warm shower or bath, to soothe irritated lungs and to help loosen respiratory secretions.

“Make sure to protect yourself and your family and get immunized,” reminded Dr. Butkiewicz.