Increase in Whooping Cough Leads to Joint Education by Public and Private Health Care Agencies
11/14/03 Portland, Ore.Oregon Health & Science University, the Multnomah County Health Department and the Oregon Department of Human Services are joining together to raise awareness about a recent increase of pertussis, or whooping cough, cases in the Portland area. OHSU has seen 10 cases (four confirmed, six suspected) since late September, while other clusters have occurred through out the metro area.
Between 1993 and 2002, an average of 85 cases of pertussis per year were reported in Oregon. Last year, however, there were 193 cases of pertussis, and this year, to date, DHS has received reports of 402 cases.
Infants are at greatest risk: Half of Oregon's infants with pertussis have been hospitalized and one in every 1,000 children younger than 1 can suffer severe complications. An 11-week-old Oregon baby died of the disease earlier this year. Adults are commonly infected, and they are often the source of infection for children.
"The fact that we are seeing more cases of pertussis underscores the need for childhood immunization," said Paul Cieslak, M.D., manager of communicable disease programs in the Oregon Department of Human Services. "While the vaccine won't eradicate the bacterium, it does prevent whooping cough. We strongly urge parents to make sure their children are fully immunized."
Pertussis can occur at any age, but most reported cases are in adults, in teens and in children older than 10. This year in Oregon, more than 70 percent of patients have been older than 10. Vaccination against the disease is recommended at ages 2, 4 and 6 months, with additional doses at 15 months and at school entry, according to Cieslak. There is no vaccine available for adults.
Pertussis can be difficult to detect because early symptoms resemble a common cold: sneezing, runny nose, low-grade fever and mild cough. Within two weeks, the cough becomes more severe and is characterized by episodes of numerous rapid coughs followed, in young children, by a whooping sound.
Treatment is available; it is effective in reducing the time a person is contagious, but does not shorten the course of illness once established.
Whooping cough is contagious even when the initial symptoms begin to appear. So it's important when experiencing symptoms of the common cold that you practice good respiratory etiquette: cover your mouth when you cough, cover your nose when you sneeze and, most importantly, wash your hands regularly.
"This is the beginning of cold and flu season, so it's important to start focusing on ways we can all prevent the spread of colds, the flu and whooping cough," said Paul Lewis, M.D., director of OHSU Hospital's Infection Control Program. "There are simple common-sense preventive measures we can all take to help protect our children and others."
Pertussis has also increased in other parts of the country. According to the Centers for Disease Control and Prevention, 5,000 to 7,000 cases are reported each year on average, and in 2002 that number rose to 8,296 cases.
"If we identify and treat cases of whooping cough early in the course, we will reduce the risk of transmission to infants who are both susceptible and at risk for severe complications," said Lewis, who is also a pediatric infectious disease physician at Doernbecher Children's Hospital. All of the OHSU cases were treated with antibiotics, as were people in the community who were in contact with or exposed to those seen at OHSU.
To prevent pertussis, children younger than 7 should be up to date on their pertussis vaccinations. Anyone with a severe "whooping" cough of more than two weeks duration should consider seeing a physician to be evaluated for pertussis. Also, to help prevent this and other serious respiratory illnesses, everyone should practice respiratory etiquette:
Cover your mouth when you cough.
Cover you nose when you sneeze.
Wash your hands regularly.
Wear a mask if you have severe symptoms of a cold or cough and you're in a health care setting.
For more information about whooping cough, visit the DHS Web site at: www.dhs.state.or.us/publichealth/acd/pertussis/index.cfm or OHSU's Web site at: http://www.OHSUHEALTH.com