By Kara Stephens

Current Status: Public Health Nemesis

If you’ve been reading the news the past few weeks, you may have heard about the recent outbreak of pertussis that has reached epidemic levels in Washington.  There have been 2,092 cases reported statewide through June 5, 2012, compared to 164 reported cases in 2011 during the same time period.  Other states are also reporting increased levels or outbreaks of pertussis. Outbreaks reported in schools and communities as well as the beginning of summer camp season highlight the importance of public awareness.  View the Pertussis Disease Villain’s rap sheet below to find out more about this public health nemesis. 

Real name: Pertussis
Known aliases: Bordetella pertussis (the bacteria that causes pertussis illness); whooping cough (for the “whoop” sound of someone gasping for air after a coughing spell).
Microbe type: Bacterium

Profile

Pertussis, also known as whooping cough, is a respiratory disease that can be fatal, especially for infants.  At first, signs and symptoms of this tricky pretender might seem like a common cold — runny nose, no or low-grade fever, and cough. That’s stage 1, when pertussis is just warming up.   After a week or two, pertussis infection delivers its cruel surprise — uncontrollable, violent coughing spells.  Severe coughing attacks often leave victims gasping for air — often described as a “whooping” sound.  However, if you have been vaccinated, the infection is usually less severe and often the “whoop” is not present. 

In infants, the cough can be minimal or not even there. Infants may have a symptom known as “apnea,” a long pause in the breathing pattern.

Preferred Method of Attack

Pertussis is primarily an “air attacker,” flying through the air looking for its next victim, when an infected person coughs or sneezes.  Many infants who get pertussis are infected by older siblings, parents or caregivers who might not even know they have the disease Pertussis loves crowded locations to encourage close contact among potential victims and to make its job easier. 

Powers & Abilities

Pertussis is highly contagious (easy to catch). Want proof? A person with pertussis will infect almost everyone in their household if those people aren’t vaccinated.

Preferred Victims

Pertussis is a bully, often causing serious and sometimes life-threatening complications in infants and young children, especially those who are not fully vaccinated.  In infants younger than 1 year of age who get pertussis, more than half are hospitalized. And of those infants who are hospitalized, 1 in 100 will die. Also, other bacterial infectors just love to join pertussis’ party, moving into a sick person’s pertussis-infected lungs to cause their own infections. These are called “secondary infections.” Pertussis can also pull off its own complications among young children, such as pneumonia, seizures, and encephalopathy (disease of the brain). For teens and adults, pertussis can be miserable. It sometimes causes rib fractures and other complications from the coughing fits, which can last for weeks or months.

Known Weaknesses 

Pertussis fears four letters — D, T, a, and P — and 2 vaccines, DTaP and Tdap.  DTaP is for infants and children and Tdap is a booster shot for preteens, teens and adults. The vaccine ammo contains diphtheria (the D), tetanus (the T), and acellular pertussis (the aP).  The term “acellular” means that the vaccine uses pieces of pertussis bacteria (not the whole bacterium cell).  By using just pieces, the vaccine can “teach” the body to protect itself, with the fewest side effects.

While vaccination provides the best protection from pertussis, some simple basic hygiene steps ‒ wash hands with soap and water, cover up coughs and sneezes, and do not share cups and silverware ‒ may  also help to keep it in check.

Criminal Record

Doctors have actually been dealing with pertussis for at least 500 years, but pertussis cases have been on the rise in the U.S. since the 1980s.  As of late, CDC has noted an increase in cases among 7-10 year olds.  During 2010, 27,550 cases of pertussis were reported in the U.S. – the most since 1959. Twenty-seven deaths were reported – 25 of these deaths were in children younger than 1 year old.

Precautions for the Public

Stay vigilant.  We may think we’ve gotten the upper hand against pertussis.  But, the disease is always scheming to get back on top.  Recent outbreaks in schools and communities as well as the beginning of summer camp season are good reminders to take action.

Children should get 5 doses of DTaP, one dose at each of the following ages:

• 2 months,
• 4 months,
• 6 months,
• 15 through 18 months,
• and 4 through 6 years.  

While 95 percent of children in the U.S. get these vaccinations, by the time they reach adolescence, vaccine protection fades.  Therefore, to increase protection against the Pertussis Disease Villain, a booster shot (Tdap) is recommended for:

• adolescents 11-18 years of age (preferably at age 11-12 years; about 70% of teens have received Tdap),
• adults 19 years and older, especially those who will have close contact with an infant (about 8% of adults have received Tdap) and
• pregnant women, preferably during the third or late second trimester. 

Tdap vaccine can protect yourself and infants you might come into contact with. And by getting Tdap during pregnancy, maternal pertussis antibodies transfer to the newborn, likely providing protection against pertussis in early life, before the baby starts getting DTaP vaccines. Tdap will also protect the mother at time of delivery, making her less likely to transmit pertussis to her infant.

Situational awareness is also of the upmost importance – listen to a recording of a child with pertussis here and read the latest information on CDC’s pertussis Web site to learn how to avoid becoming the Pertussis Disease Villain’s next victim.