By Carl Rachel
Reports of pertussis cases have increased 625 percent in Hunterdon County compared to last year. While case numbers for 2011 and 2012 are not official, it is known that for the period between September 2010 through May 2011, eight confirmed and probable cases of pertussis — also known as whooping cough — occurred in Hunterdon County. During that same period for 2011 to 2012, 50 cases occurred, with 72 percent of these cases appearing in Alexandria, Clinton Township, and Raritan Township. In addition to these 50 cases, another 15 cases remain under investigation from this latest period.
”We’re witnessing an increase in pertussis in Hunterdon County,” said Rose Puelle (epidemiologist for the Hunterdon County Division of Health). “Since November, we’ve continued to see consecutive months of higher pertussis cases here in the county than in the previous period; 47 cases compared to four cases.”
Pertussis is a serious bacterial infection of the respiratory tract. It is a contagious disease usually spread through the air by close, indoor, repeated contact with an infected person, typically by talking, coughing, or sneezing nearby. Indicative of how severe pertussis can be, of all cases in those less than a year old, 68 percent require hospitalization.
”Pertussis is a communicable but vaccine-preventable disease,” according to Ms. Puelle. “It can cause serious illness and even death ? especially in infants less than six months of age who are too young to be fully vaccinated.”
Pertussis can infect anyone. The best way to reduce the threat of the disease spreading to the most at-risk population is to make sure that all children under age seven receive all their pertussis vaccinations on time, and that adolescents and adults receive booster vaccinations.
Children should receive four doses of DTaP vaccine between 2-18 months of age and an additional dose before starting school. Adolescents and adults ages over 10 years of age can receive booster shots called Tdap to enhance their immunity.
”Because pertussis is infectious and can cause serious illness in infants and young children, state law requires local public health staff to immediately begin investigating cases,” noted Ms. Puelle. “Among our goals are verifying the diagnosis of pertussis and guiding measures to be taken to reduce the spread of the disease in the community.”
A vital part of the investigations done by the county public health nursing division is to identify close contacts of confirmed cases. During public health investigations, Stephanie Beach, communicable disease nurse with the Hunterdon County Department of Human Services. talks to parents about their child’s illness and explains why close contacts may need to see a physician.
”We’re especially concerned that as this illness continues to persist in the county, some younger residents may take pertussis to summer camp with them,” according to Ms. Beach.
Pertussis is one of the most commonly occurring vaccine-preventable diseases in the United States. But even with the success of pertussis vaccines, people continue to get pertussis. Since the 1980s, there has been an increase in the number of cases of pertussis, especially among teens (10–19 years of age) and infants less than 6 months of age. Nationally, during 2010 there were 27,550 reported pertussis cases including 25 infant deaths. This is the most number of reported cases in 52 years — since 1959 when there were 40,005 cases.
Pertussis starts with cold symptoms and a cough that gets progressively worse during the weeks that follow and can last for months. Symptoms usually include a long series of coughing fits that can be followed by whooping noises, vomiting, turning blue, or difficulty catching one’s breath. Older children, adults, and very young infants may not exhibit the characteristic whoop sound. Coughing often intensifies at night, and cough medicines usually do not provide adequate relief. Symptoms and complications of pertussis generally are less apparent among older children and adults and may not be as severe in those who have received vaccinations.
Serious complications including pneumonia can result among all age groups. Although deaths related to pertussis are rare, they do occur, especially among young infants who have not yet started or completed the pertussis vaccinations. According to the Centers for Disease Control the younger the infant is with a pertussis infection, the more likely treatment in the hospital will be needed.
”Persons diagnosed with pertussis have to take the full course of antibiotics prescribed by their physician and remain isolated until they have completed five days of treatment in order to limit potential spread of the disease,” said Dr. Cindy Barter, county health division medical director. “Since pertussis can be sprayed into the air by those who are sick and coughing, it is important to stay home from school or work if you are ill.”
If you suspect that you or a family member has pertussis, consult your health care provider. Likewise, if you have a cough of seven days or longer with explosive or sleep-disturbing coughing spasms, contact your physician for possible laboratory testing and treatment. Information about pertussis in English and Spanish is available on the Division of Health’s website at www.co.hunterdon.nj.us/health.htm.
Carl Rachel is director, Media/Public Relations, Hunterdon County Division of Public Health.
