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Written by:
Emily Sherman
10/1/2010 2:39 PM
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Pertussis Outbreak - California Pertussis Outbreak
An outbreak of pertussis or whooping cough in California has likely caught many people by surprise, after all, most kids get vaccines to protect them against pertussis as infants and toddlers and a booster before they start kindergarten.
There is even a newer tetanus booster shot (Tdap) that includes the pertussis vaccine to help teens and adults get renewed protection against pertussis, which is important, since the immunity that the pertussis vaccine offers is at its strongest for only about 3 years and then gradually decreases over the next 2 to 7 years.
Pertussis Outbreak
So why is pertussis still a problem? Many teens and adults haven't gotten a Tdap vaccine yet, can still get sick with pertussis, and can infect infants who haven't completed their three dose primary series of pertussis vaccines when they are about six months old. The fact that some parents are refusing vaccines or using alternative immunization schedules likely isn't helping prevent these types of outbreaks of vaccine preventable infections either.
California Pertussis Outbreak
So far in California, as of September 7, 2010, there are 3,834 confirmed cases of pertussis, with the highest rates in children under three to six months of age. Younger infants also have the highest rates of hospitalization and the most deaths, which has now increased to a total of eight.
To help combat this outbreak, the California Department of Public Health (CDPH) is urging that everyone get vaccinated against pertussis, including:
- anyone 7 years and older who is not fully immunized, including those who are more than 64 years old,
- women of childbearing age, before, during, or immediately after pregnancy, and
- other people who have contact with pregnant women or infants.
Preventing a Pertussis Outbreak
Even if you are not in California, this outbreak should be a reminder of how serious pertussis infections are and the importance of pertussis vaccines. Keep in mind that in addition to completing the DTaP (Diphtheria, Tetanus, and acellular Pertussis) series of shots before starting kindergarten and getting a Tdap booster shot when they are 11 to 12 years old (or when they are older if they missed it), the Advisory Committee on Immunization Practices (ACIP) recommends that adults between the ages of 19 and 64 get a Tdap (Tetanus, Diphtheria, and acellular Pertussis) vaccine if it has been 10 or more years since their last tetanus booster shot.
Adults who will have contact with infants less than 12 months old, including parents, grandparents over 65, child-care providers, and health care workers, should get a Tdap vaccine if they have not had one yet, even if it has been less than 10 years since their last tetanus booster.
Symptoms of Pertussis
Since rates of pertussis are increasing with the California pertussis outbreak and in other areas of the country, it is important that parents be able to recognize the symptoms of pertussis.
Pertussis symptoms usually start just like regular cold symptoms about 6 to 21 days after being exposed to someone else with pertussis, often an adult with a chronic cough. These initial pertussis symptoms typically last a week or two and might include a low-grade fever, runny nose, congestion, sneezing, and a cough.
Next, just as you would be expecting a child's cold symptoms to be improving, the child with pertussis actually starts to get worse, and develops symptoms which can last an additional 3 to 6 weeks, including:
- coughing spells or fits, which might end in the classic "whoop" sound
- vomiting after coughing spells (post-tussive emesis)
- cyanosis or blue spells after coughing
- apnea or episodes where an infant actually stops breathing during or after a coughing spell
These pertussis symptoms then gradually improve over the next few months.
Parents should see their pediatrician if they think that their child might be developing pertussis symptoms or seek more immediate medical attention if your younger child has severe symptoms, such as apnea or prolonged coughing fits.
Sources:
California Department of Public Health. Number of Cases of Pertussis in California: Pertussis Summary Report (8-31-2010). Accessed September 2010.
CDC. Preventing Tetanus, Diphtheria, and Pertussis Among Adults: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine. MMWR. December 15, 2006 / 55(RR17): 1-33
Article Source: http://pediatrics.about.com/od/immunizations/a/910-pertussis-outbreak.htm