Coughing it up

Last week the Virginia Department of Health issued a statement asking citizens to take measures to prevent the spread of pertussis, more commonly known as whooping cough. Health officials have documented an increased number of whooping cough cases throughout the country, including a 72 percent increase in reported cases from 2009 to 2010 in Virginia.

"Although pertussis traditionally occurs in cyclical peaks, the twofold increase in Virginia since 2007 is cause for concern," said Virginia Health Commissioner Karen Remley, MD.

Whooping cough is a highly-contagious, bacterial infection that causes cold-like symptoms along with severe coughing that can last for weeks. The name is derived for the "whoop" sound made by the ill when they gasp for breath after a violent coughing spell. Children less than one year of age are in the most danger as the disease can cause lung infections and seizures. On rare occasions, pertussis is fatal among infants.

"The number of outbreaks continuing throughout the state means that babies too young to be vaccinated are especially at risk," said William B. Moskowitz, MD, president of the Virginia Chapter of the American Academy of Pediatrics. "Many of those infants are being hospitalized with serious disease."

Last week, the Blue Mountain School in Floyd County, Va. closed temporarily after the emergence of whooping cough among students. Shelly Emmett, director of the private school, said that the closing was part of an attempt to halt the spread of the sickness and to administer to the infected. According to Dr. Molly O'Dell, the director of the New River Health District, at least 35 cases were confirmed by lab tests and clinics.

Over 21,000 people, many of them children, had whooping cough last year in the United States, the highest number since 2005. The Center for Disease Control and Prevention attributed at least 26 deaths across the nation to pertussis in 2010. Whooping cough was once a common disease in America until the development of vaccines in the 1940s. But the disease is back on the rise thanks to a decreasing number of vaccinated people and the weakening immunity of those vaccinated over a decade ago.

California state officials reported 8,300 cases of pertussis in 2010, including 10 infant deaths. Texas, New York, Washington, Minnesota, and Illinois were among many states that reported increased numbers of whooping cough cases last year.

In March, North Carolina health officials warned medical providers to watch for whooping cough after several cases were discovered at a child care center in Henderson County. Linda Weldon, the Henderson County Health Department supervisor, said that whooping cough is often undetected because of its similarity to other illnesses.

Last month, the Oklahoma Department of Health announced that all public school students entering the 7th grade were required to be vaccinated for the sickness. Oklahoma has seen a large rise in pertussis cases and is taking measures to halt the spread, especially among those who are most vulnerable.

Health officials are most concerned with infants catching the illness from adults around them. While approximately 95 percent of children have had at least three vaccination shots, studies suggest that as low as 6 percent of adults are fully immunized. The percentage of adults immunized is small because the adult whooping cough vaccine was not licensed in the US until 2005.

The Center for Disease Control and Prevention recommends a single dose of Tdap for adults over 65, breastfeeding mothers, and healthcare professionals who come into contact with patients on a daily basis. The CDC also recommends that children receive 5 doses of the DTaP vaccine with the first dose being administered at 2 months of age. Health officials advocate a single booster shot of the vaccine for adolescents, preferably at age 11 or 12, and for adults who have never had a booster shot.

Symptoms of pertussis include fits of coughing, difficulty breathing, and vomiting, but these symptoms are usually milder in older children and adults. Antibiotics can help lessen the severity of the illness and halt its spread to others.

The Associated Press contributed to this report.

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