ESCANABA - Pertussis has been on the rise in the past few years across the state of Michigan; there's even more cases locally this year than a year ago, according to a local health official.
Pertussis, more commonly known as whooping cough, is a respiratory illness that spreads easily by coughing and sneezing. According to Jennie Miller, immunization and communicable disease coordinator at Public Health - Delta & Menominee Counties, the illness begins like the common cold, with runny nose or congestion, sneezing, and mild cough or fever. Severe coughing begins after just one to two weeks. Pertussis is most severe for babies, with more than half of infants less than a year old who catch the illness hospitalized.
Infants and children who have the disease repeatedly cough violently and rapidly until the air is gone from their lungs, forcing them to inhale with a loud "whooping" sound, she said. Coughing can last for weeks or even months.
Jennie Miller, immunization and communicable disease coordinator at Public Health — Delta & Menominee Counties, prepares a Tdap vaccination, which protects against tetanus, diphtheria, and pertussis, more commonly known as whooping cough. (Daily Press photo by Jason Raiche)
"Infants and young children, especially those who are not fully vaccinated, are more at risk of serious and sometimes life-threatening complications of pertussis," said Miller. "However, pertussis is highly contagious and can affect individuals of all ages."
Typically adults and adolescents have a milder form of pertussis, but they can still easily spread the infection to others, including infants and young children.
Miller said the number of pertussis cases has been on the rise in the past few years. In 2010, 27,550 cases of pertussis were reported in the U.S., the highest number of cases reported since 1959. This number dropped to 18,719 cases in 2011. Michigan has seen a similar trend.
"In Michigan there has been a worrisome steady increase in pertussis over the past decade, peaking in 2010 with over 1,500 cases reported," Miller said.
As of the end of Oct. 15, 2012, the Michigan Department of Community Health had received 634 reports of pertussis cases and one pertussis-related death. Last year, as of Oct. 31, 2011, there were 572 case reports.
Miller said in the Upper Peninsula, more than 125 cases of suspected, probable, or confirmed pertussis have been reported. However, she says this number is likely to be an underestimate of actual cases, since many do not seek medical care for their symptoms and because a diagnosis of pertussis isn't always considered by those who are seen.
"In Delta and Menominee counties, we have had 48 cases of pertussis reported to us from Nov. 2011 until Nov. 2012," said Miller. "Within that time frame for the previous year, we had only one case."
Since pertussis appears to be nothing more than the common cold in its early stages, it is often not suspected or diagnosed until more severe symptoms appear.
According to Miller, infected people are most contagious up to approximately two weeks after the cough begins, but antibiotics may shorten this amount of time.
As it progresses, traditional symptoms include fits of many, rapid coughs followed by a high-pitched "whoop," though not everyone with pertussis coughs or "whoops." Other symptoms include vomiting and exhaustion following coughing fits. Those with chronic lung diseases may suffer more severe symptoms.
The best way to prevent pertussis is to get vaccinated. The vaccine known as DTaP is licensed for children 6 weeks through 6 years old. Children get the DTaP vaccine routinely at 2 months, 4 months, 6 months, 15-18 months, and 4-6 years of age. Tdap is a one-time booster given to adolescents and adults who haven't yet received a dose. Both DTaP and Tdap protect against pertussis, as well as tetanus and diphtheria.
"Make sure infants and young children get their recommended five shots on time," Miller said. "Protection from the childhood vaccine fades over time. Adolescents and adults need to be revaccinated, even if they were completely vaccinated as children. This is especially important for families with new infants."
Pertussis vaccines are very effective in protecting from the illness, but Miller noted that a fully vaccinated person of any age still has a chance to catch the contagious disease if it's circulating the community. The infection is usually less severe for those who are vaccinated.
"If you or your child develops a cold that includes a severe cough or a cough that lasts for a long time, it may be pertussis," said Miller. "The best way to know is to contact your doctor."
Doctors may recommend preventive antibiotics to people who come in close contact with someone who has the illness, including all household members, regardless of age and vaccination status. This also may prevent or reduce the chance of catching the illness.
For more information on pertussis, visit the Centers for Disease Control and Prevention's website at www.cdc.gov.