Coughing That Won’t Quit?

Think Pertussis (Whooping Cough) Cases Double in First Part of 2018

The number of cases of whooping cough in Santa Cruz County has more than doubled during the first four months of 2018. In January through April of this year, 11 cases of pertussis, or whooping cough were confirmed, compared to 5 cases in the same period of 2017.

“Pertussis disease rates are cyclic, peaking every 3 to 5 years. The last epidemic in California was 2014. We don’t know yet if 2018 or 2019 will turn out to be peak years, but vigilance is in order,” said Naomi Lobell, Immunization Coordinator for Santa Cruz County Health Services Agency.

Dr. Arnold Leff, the County Health Officer emphasized the importance of immunizations.  “Pertussis is covered in the DTaP shot, given to babies at age 2 months, 4 months, 6 months and 12 months. Booster shots are given again before kindergarten and middle school. Summer is a good time to get immunizations, so students are ready for school in the fall. Adults who have never received a dose of Tdap should also get vaccinated against pertussis,” stated Dr. Leff.

Back in 2010, a statewide outbreak of whooping cough killed 10 people, and required more than 800 hospitalizations in the 9,000 people who caught the disease, according to the National Institutes of Health. It was the largest outbreak of the disease reported in California in 60 years.

According to the US Centers for Disease Control and Prevention, whooping cough usually starts with cold-like symptoms and possibly a mild cough or fever. In babies, the cough can be minimal or not even there. Babies may have a symptom known as “apnea.” Apnea is a pause in the child’s breathing pattern. Pertussis is most dangerous for babies. About half of babies younger than 12 months who get the disease need to be hospitalized.

Early symptoms can last for one to two weeks and usually include:

• Runny nose
• Low-grade fever (generally minimal throughout the course of the disease)
• Mild, occasional cough
• Apnea — a pause in breathing (in babies)

Pertussis in its early stages appears to be nothing more than the common cold. Therefore, healthcare professionals often do not suspect or diagnose it until the more severe symptoms appear.

After one to two weeks and as the disease progresses, the traditional symptoms of pertussis may appear and include:

• Paroxysms (fits) of many rapid coughs followed by a high-pitched “whoop” sound
• Vomiting (throwing up) during or after coughing fits
• Exhaustion (very tired) after coughing fits

Pertussis can cause violent and rapid coughing, over and over, until the air is gone from your lungs. When there is no more air in the lungs, you are forced to inhale with a loud “whooping” sound. This extreme coughing can cause you to throw up and be very tired. Although you are often exhausted after a coughing fit, you usually appear well in-between. Coughing fits become more common and worse as the illness continues and often occurs more often at night. These coughing fits can go on for up to 10 weeks or more.

Some things to consider:

• Consider visiting your physician for a cough illness when the cough becomes increasingly severe, even if the ill person has been vaccinated against pertussis.
• Pertussis can occur in any season including summer, and people who have been vaccinated in the past may have a milder presentation and overall illness than someone who is unvaccinated.
• Pregnant women should be vaccinated against pertussis in the third trimester of every pregnancy.

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For more information go to www.cdc.gov/pertussis