Credit CDC’s Pertussis page.
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Two weeks ago, in California: Pertussis Rising (Again), we looked at the early, steep rise in Pertussis cases reported in California this year, along with a look back at the the history of the disease, and the vaccine used to combat it.
Credit CDC
After all but eliminating the disease in the United States in the 1970s, Pertussis is back, albeit at only 1/10th the levels it once was. The reasons behind these increases are complex, and not entirely understood, but some factors are believed to be:
- lower vaccination uptakes in children and adults
- the move away from whole cell pertussis vaccines to safer (but somewhat less protective) acellular vaccines in the 1990s
- evolutionary changes in the Bordetella pertussis bacteria.
Whooping cough outbreaks are cyclical, and we see localized outbreaks increase every three to five years. The last `big’ year for Whooping cough in California was 2010, but 2014 looks like another contender. Yesterday, the state of California formally declared this year’s outbreak an epidemic.
More than 800 new cases have been reported in the last two weeks
The number of pertussis (whooping cough) cases in the state has reached epidemic proportions it was reported today by Dr. Ron Chapman, director of the California Department of Public Health (CDPH) and state health officer.
As of June 10, there have been 3,458 cases of pertussis reported to CDPH in 2014, more than were reported in all of 2013. Over 800 new cases have been reported in the past two weeks.
Pertussis is cyclical and peaks every 3-5 years. The last peak in California occurred in 2010, so it is likely another peak is underway.“Preventing severe disease and death in infants is our highest priority,” says Dr. Chapman. “We urge all pregnant women to get vaccinated. We also urge parents to vaccinate infants as soon as possible.”
Infants too young to be fully immunized remain most vulnerable to severe and fatal cases of pertussis. Two-thirds of pertussis hospitalizations have been in children four months or younger. Two infant deaths have been reported.
The Tdap vaccination for pregnant women is the best way to protect infants who are too young to be vaccinated. All pregnant women should be vaccinated with Tdap in the third trimester of each pregnancy, regardless of previous Tdap vaccination. In addition, infants should be vaccinated as soon as possible. The first dose of pertussis vaccine can be given as early as 6 weeks of age.
Older children, pre-adolescents, and adults should also be vaccinated against pertussis according to current recommendations. It is particularly important that persons who will be around newborns also be vaccinated.
“Unlike some other vaccine-preventable diseases, like measles, neither vaccination nor illness from pertussis offers lifetime immunity,” says Dr. Ron Chapman. “However, vaccination is still the best defense against this potentially fatal disease.”
The symptoms of pertussis vary by age. For children, a typical case of pertussis starts with a cough and runny nose for one to two weeks. The cough then worsens and children may have rapid coughing spells that end with a “whooping” sound. Young infants may not have typical pertussis symptoms and may have no apparent cough. Parents may describe episodes in which the infant’s face turns red or purple. For adults, pertussis may simply be a cough that persists for several weeks.CDPH is working closely with local health departments, schools, media outlets and other partners to inform the general public about the importance of vaccination against pertussis.
Pertussis data, including the number of cases in each county, can be found on the CDPH website, and is updated regularly
