Pertussis back in local area
The number of cases of whooping cough — Pertussis — is growing in the U.S., including in central Illinois where seven Champaign County schools have confirmed cases.
Seven schools in Champaign County have confirmed cases of whooping cough, among them Rantoul High School where local health authorities have declared an outbreak. There are 10 confirmed cases in Douglas County and two in Clark County. So far this year, there have been 551 confirmed cases of whooping cough, according to information provided by the Illinois Department of Public Health.
To date this year, there have been 40 cases of this contagious illness, also called pertussis, in Champaign County, with 27 confirmed cases since mid-October, according to Rachella Thompson-Brown, communicable disease investigator for the Champaign-Urbana Public Health District.
"We're just really seeing a lot of pertussis this year," she said.
The outbreak at Rantoul High School has 20 confirmed cases to date, Thompson-Brown said.
There have also been two confirmed cases at Thomasboro Grade School, one at Villa Grove High School, two at J.W. Eater Jr. High School in Rantoul, one at Heritage High School in Broadlands and, most recently, two cases at Mahomet-Seymour schools — one involving a third grader at Lincoln Trail Elementary School and one a seventh grader at the junior high school.
All these other cases have been confirmed in the past couple of weeks, and none have been linked to the Rantoul High School outbreak, Thompson-Brown said.
The case list could grow, she said. Pertussis has a 21-day incubation period, and there remain potential cases under investigation.
Children and teens who are coughing are being referred to their family physicians for testing and treatment and isolated for five days, Thompson-Brown said. Treatment is a five-day course of antibiotics, she said.
It takes 2-5 days to lab-confirm a case of pertussis, so by the time a case is confirmed some of the students may already have been treated and considered free to leave isolation.
Pertussis starts with symptoms similar to a common cold, with a runny nose, sneezing, low-grade fever and a mild cough. The cough grows more severe in a week or two.
No longer a distant memory from the Great Depression, whooping cough has made an alarming resurgence in the United States. Current infant vaccinations may no longer be enough, since immunity against the disease seems to wear off at adolescence, and the government is now considering a booster shot to help fight the often deadly illness.
Experts at the Center for Disease Control (CDC) note whooping cough is a highly contagious bacterial infection characterized by violent coughing fits, gasps for air that resemble "whoop" sounds, and vomiting. The symptoms can last for up to two months, and while an antibiotic is available to prevent spread of the disease, "it won't shorten the illness in the person already infected," says Trudy Murphy, a medical epidemiologist at the Center for Disease Control (CDC). Complications from the disease can include pneumonia, hernia and physical lung damage.
While incidence of the disease plunged following development of the vaccine in the 1940s, numbers have been steadily increasing since the 1970's. A preliminary CDC count estimated over 11,000 pertussis cases in the past year, an increase of over 2,000 from the previous year and the highest count recorded in 30 years.
Regional outbreaks have been reported across the country, from New Hampshire and Vermont to Ohio and Pennsylvania and now central Illinois.
Whooping cough is often fatal to young babies; while older patients generally recover, they are the major source of infection for vulnerable infants. According to an AP report, the disease has increased by 72 percent since 1990 in babies below 4 months of age.
Children are supposed to begin an immunization series against pertussis at two, four and six months to confer protection, with two additional doses until their sixth birthdays. But Stephen Aronoff, M.D., Chairperson of the Department of Pediatrics at Temple University School of Medicine, says that he sees "a large number" of children above six months with the disease, a sign of "decreased acceptance of the vaccine by parents."
Indeed, the latest figures from the CDC show that, from 2002-2003, only about 83% of infants were vaccinated against pertussis. "So there is room for improvement," says Murphy. According to Dr. Carol Stanwyck, author of a CDC study on lags in immunization for young children, pre-school vaccination policies are poorly enforced.
It has been found that immunity against pertussis declines five to 10 years after the vaccine series; concerns that this may contribute to the resurgence have prompted the U.S. government to look at a new option: a booster shot for adolescents. Canada, Germany, France, and Australia currently have this kind of protocol in place.
In the United States, manufacturer GlaxoSmithKline has submitted a booster for FDA approval: "Boostrix" would add a pertussis component to the vaccine cocktail against tetanus and diphtheria that is currently given to 10-18 year-olds. Competitor Aventis Pasteur plans to follow suit by targeting adults as well.
Adolescents and adults who have lost immunity become more likely to get the disease, and because it is less severe in older individuals — not much more than a bad cough — it can often go undiagnosed. The problem then arises when they pass the disease on to babies