Genesee County Health Department

Better Life Through Better Health

Release Date: May 19, 2010

End Date: June 16, 2010

Contact Person: Fatema Mamou, Epidemiologist

Phone: (810) 768-7971 or (810) 691-5118

RE: Pertussis Outbreak

The outbreak of pertussis, also known as whooping cough, in Genesee County continues to escalate. Nearly every community in Genesee County has been affected by this outbreak. Spread of this disease has been seen in group settings including schools.  The majority of the cases have been among those 5 to 24 years of age. This increase is also occurring state-wide and one infant in Michigan has died from pertussis this year. Genesee County is being affected especially hard by this outbreak with a 1500% increase in the disease in 2010 compared to this time last year. The Genesee County Health Department (GCHD) is informing the community of this ongoing outbreak and reminding everyone to be aware of signs and symptoms of pertussis.

There are likely more cases occurring because pertussis is often an unrecognized and undiagnosed prolonged cough illness. This is particularly true among adolescents and adults because they may experience a milder course of illness but are still very contagious and can spread the disease to people in close contact with them. To ensure that adolescents are properly vaccinated the Michigan Public Health Code has been updated and will require that children entering the 6^th grade in the 2010-2011 school year who are 11 years or older have the booster dose of the vaccine that protects against pertussis (Tdap) in order for school entry. Young children, especially infants, are at the greatest risk for severe pertussis disease and serious complications and it is often adolescents and adults who spread the infection to young children. It is critical that adolescents and adults, especially those who have contact with infants and young children, are vaccinated against pertussis, and obtaining boosters if needed.

Symptoms of pertussis begin like a cold and include fever, runny nose and coughing episodes that gradually become more severe. Coughing episodes persist and become frequent even after cold symptoms subside and can last 1 month or longer.  Coughing spells may be intense and followed by a crowing or high-pitched whoop as the patient tries to take a breath.  Infants less that 5 months and adults often do not have the “whoop”. Coughing episodes may be severe and difficult to control and are more frequent at night. In some cases gagging and vomiting occur after coughing spells and the person may be become blue in the face from lack of air. Between coughing spells the person often appears well.

The GCHD is reminding health care providers that pertussis is increasing in the community and to consider it in their differential diagnoses. Those diagnosed with pertussis should be treated with an appropriate antibiotic. Persons exposed to a case of pertussis should make sure that they are properly vaccinated against pertussis. In some situations, those in very close contact to a case of pertussis may need treatment to prevent the disease. Because no vaccine is 100% effective, it is important that treatment be given to those close contacts regardless of vaccination status.

Health care providers should also ensure that their patients are fully vaccinated. Vaccination against pertussis is the best way to control and prevent the disease. Pertussis vaccine is administered in combination with diphtheria and tetanus vaccine (DTaP) in a five-dose primary series and protects children against whooping cough. Immunity from the vaccine wears off over time so there is an important need for booster doses of pertussis vaccine in adolescence and adulthood. The booster dose of the vaccine that protects against pertussis (Tdap) is recommended for adolescents and adults aged 11-64 years. The GCHD strongly recommends checking your immunization status, as well as your children’s.

 Symptoms of pertussis begin like a cold and include fever, runny nose and coughing episodes that gradually become more severe. Coughing episodes persist and become frequent even after cold symptoms subside and can last 1 month or longer.  Coughing episodes may be severe and difficult to control and are more frequent at night. In some cases gagging and vomiting occur after coughing spells and the person may become blue in the face from lack of air. Between coughing spells the person often appears well.

Anyone who has symptoms that he or she thinks might be pertussis should consult a health care provider. For more information see the GCHD website at www.gchd.us.

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