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Pertussis Concerns Continue in Western Nevada County

The Nevada County Public Health Department continues to receive reports of Pertussis (Whooping Cough) which is widespread in western Nevada County. As of May 14, 2013, there have been 41 cases reported in 2013, 22 in the past three weeks. Patients have ranged from 3 months of age to seniors. No hospitalizations or deaths have been reported. 28 cases have been confirmed by laboratory testing or are closely linked to someone confirmed by testing. The health department continues to work with local healthcare providers to identify additional cases.

Infants are at the greatest risk of contracting Pertussis and having severe complications from it, so protecting infants is critical.  Most babies who get ill with Pertussis get it from a household contact, often the mother or a brother or sister attending school; that is why those who are pregnant or live with or care for babies are a high priority for vaccination and children in school are a high priority for vaccinations.  Vaccination for Pertussis has been shown to result in decreased severity of symptoms for individuals who do become infected. 

 Most adults in the US have not been recently vaccinated against Pertussis as many Americans don’t know that immunity from the vaccine (or from the illness) wanes with time and a booster is recommended. In outbreaks, cases of whooping cough occur in vaccinated and unvaccinated individuals. However, unvaccinated children are at least 8 times more likely than fully vaccinated children to get Pertussis, according to the Centers for Disease Control and Prevention (CDC). 

Pertussis vaccines are recommended for people of all ages.  Infants and children should receive five doses of DTaP for protections.  Doses are given at 2, 4, and 6 months, then between 15-18 months and again at 4-6 years of age.  Infant vaccination can start as early as 6 weeks of age. A booster of Tdap is given to pre-teens 10-12 years of age.  Almost all adolescents or adults who did not receive Tdap as a pre-teen are recommended to receive one.  Tdap is particularly important for pregnant women and others who care for infants.  A new recommendation is that pregnant women receive a Tdap with each pregnancy.

 Pertussis is a bacterium that spreads easily from person-to-person through coughing and sneezing.  Pertussis outbreaks are difficult to manage because Pertussis starts off looking like a common-cold before the characteristic whoop or coughing fits appear.  Also, patients with Pertussis are considered contagious from the onset of symptoms until 3 weeks of cough or 5 days of effective antibiotics.  After exposure, Pertussis can incubate in the body for up to 3 weeks before symptoms start. The vaccine is effective but not 100% and immunity wanes. Plus, many people with Pertussis never seek medical care. All these factors mean that Pertussis outbreaks can last for months.

 Strategies to control Pertussis outbreaks include increasing immunization rates, especially for those who are around infants.  Also, post-exposure antibiotics are recommended for household contacts of contagious patients as well as close contacts who are at high risk of more severe disease (such as pregnant women, infants, and those with weakened immune systems). As part of its investigation, the health department has been referring household and high-risk contacts to their regular healthcare providers for care.

Pertussis outbreaks occur every 3-5 years and the last large California outbreak was in 2010 when more than 9,000 cases were reported in the state.

Pertussis can cause serious illness, hospitalization and death — especially in infants who are too young to be well-protected by vaccines. You can help protect your baby from pertussis by:

  • Getting a pertussis vaccine (Tdap) if you are pregnant
  • Encouraging those around your baby to get a pertussis vaccine
  • Making sure your baby gets his pertussis vaccines on time

 

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