Something to cough at

Glenn Wallace
Posted

It starts off like a typical cold.

But then the coughing starts: long, uncontrollable bouts of coughing that can result in the need to make a “whooping” inhalation of breath between coughs in order to breathe.

“What we know is that very young kids are the most vulnerable to severe pertussis disease (whooping cough), and it can be really deadly for the infants that have no protection,” Nancy Braden, spokeswoman for Jefferson County Public Health, said.

It is a bad year for whooping cough across the nation and the state. In recent weeks the Colorado Department of Public Health and Environment (CDPHE) reports seeing nearly twice as many cases as the five-year seasonal average.

“CDPHE has said the numbers have reached epidemic level because we’re seeing so many cases across the state,” Braden said.

Jeffco is seeing its fair share of cases, most in recent weeks. Since Jan. 1, 151 cases of pertussis have been confirmed in the county, Braden said.

Several Jeffco schools have seen the outbreak spread to their student population. Melissa Reeves, spokeswoman with Jeffco Public Schools, said the district’s protocol is to take students with symptoms to the nurses’ office and contact parents to suggest they have their child tested for the disease.

“We are emphasizing the immunization clinics that the county is offering, and we are training our staff on how to spot symptoms,” Reeves said.

Doctors who confirm cases of the disease then notify state and county health departments. Principals of schools can then send out a notification letter to parents, letting them know that the student body has been exposed.

If diagnosed, doctors prescribe antibiotics to lessen symptoms and contagiousness, and ask that all household members of the infected individual sequester themselves for five days.

Whooping cough is an infection of the lungs, caused by bordetella pertussis bacteria. According to the Centers for Disease Control and Prevention, the nation typically sees a flare-up of the disease every three to five years, with this year looking like the worst outbreak since at least 2000, when the CDC began keeping annual monitoring records.

This year, 29,000 cases had been reported as of last week, with l14 pertussis-related deaths reported nationwide so far this year. The most vulnerable group is infants younger than 3 months of age.

“It can be really deadly for the infants to have no protection,” Braden said.

The disease is most contagious in the two weeks before the worst of the coughing symptoms start. Not everyone develops the signature “whoop,” and an infected person may not cough at all. Infants may simply stop breathing for a significant length of time. Even after the body begins to recover from pertussis, it remains vulnerable to other respiratory diseases and relapsing coughing fits for weeks afterwards. It is possible to contract the disease even with a current vaccination. The Centers for Disease Control says one to three out of 10 vaccine-takers can still fall ill to the disease, but that their symptoms tend to be less severe and much less life-threatening in young children.

Braden says part of the upsurge of cases may stem from confusion about vaccinations.

Pertussis immunizations are recommended for all children and adults, but getting the vaccination is not a straightforward process. Two different vaccines have been developed, the DTaP and the Tdap, and are given to different age groups. The DTaP vaccine is administered at children ages 2 months, 4 months and 6 months; again at 15 to 18 months; and a third time at 4 to 6 years. Tdap is the vaccination required when a child enters sixth grade and is recommended for all adults, especially those who take care of or have close contact with infants.

Braden said another cause for the disease spread could be “people who, for whatever reason, are choosing not to immunize their children, and putting a much larger group of children at risk as a result.”

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