County sees increase in whooping cough cases; flu season starts slow
An increase in reported pertussis cases in Minnesota has physicians and other health officials urging teenagers and adults to get pertussis booster vaccinations to prevent spreading the disease to infants and young children.
Washington County health officials have seen a significant increase in pertussis cases this year, according to Fred Anderson, an epidemiologist with the Washington County Department of Public Health and Environment.
“It has been this entire, predominantly in the summer and fall months,” he said. “We’re very much in line with the state and nation with pertussis.”
According to the Minnesota Academy of Family Physicians, the state Department of Health has reported 3,950 pertussis cases this year, the highest number since the 1940s before the pertussis vaccine was developed.
The vast majority of the county’s pertussis cases involve persons who have been appropriately immunized for their age, Anderson said.
“It’s not real clear right now,” he said about why pertussis is striking those immunized against the disease. He added that the county is participating in a study with the MDH and Centers for Disease Control to learn if an early waning of the vaccine or a stronger virus is causing the spike in pertussis cases.
Pertussis got the nickname “whooping cough” due to the swelling of victims’ windpipe and voice box that gave patients a characteristic “whoop” sound to inhalation.
“It usually starts with a mild respiratory illness; a mild runny nose, a mild cough,” Anderson said, adding that patients usually have no fever, but will experience a worsening cough at night.
Eventually, pertussis sufferers experience fatigue and a persistent cough lasting five to 10 weeks, Anderson added.
“Whooping cough would last for weeks,” said Dr. Glenn Nemec, a Monticello family physician. “There was no effective treatment, and once in a while the swelling would close off the windpipe and voice box completely. Unless the child was actually in the hospital when this happened, it frequently resulted in death.”
The original pertussis vaccine was effective, but had to be injected in the muscle in a series of five shots over five years. That led to sore arms, fevers and occasionally more serious reactions. The vaccine has been refined so there are fewer side effects.
However, the MAFP also notes that the modern pertussis vaccine starts wearing off as soon as five years after the last dose. By age 15, a person has only 50 percent protection from the pertussis germ and that protection is less each year.
This means adults can get pertussis fairly easily, but do not get very sick. Because symptoms are so mild, many adults never get sick enough to seek care and don’t consider pertussis a possibility. These adults then go out a cough on infants and children too young to have completed a full series of shots.
“On a positive note, supportive care for pertussis is much more advanced than in the past which means death due to the disease is very rare,” Nemec said. “That doesn’t mean pertussis shouldn’t be taken seriously. It’s not unusual for patients to be hospitalized due to the illness and some even need to be put on ventilators.”
Anderson said antibiotics are used to treat pertussis and if the disease is caught early, symptoms can go away.
But the best way for persons to avoid catching, then spreading pertussis is to talk to their doctor, review their immunizations and get a booster Tdap vaccine, Anderson said. Parents should make sure their children are up-to-date on their vaccinations and if someone has a severe cough, a cough that comes in “spasms” or a cough lasting over a week, they should see their doctor and ask about pertussis.
“It is not likely we will ever exterminate pertussis,” Nemec said. “But if everyone gets their shots, watches for symptoms and gets in early for testing, we can relegate whooping cough to the rare disease file.”
Some good news on the county health front is flu season is off to a very slow start, Anderson said.
“At this time of year, we pick up on and hear about influenza-type cases,” he said. “I have not heard from school nurses, physicians and other health-care practitioners and long-term care facilities about cases.”
Anderson said flu symptoms include fever, cough, fatigue, muscle aches and a general malaise. Treatment includes plenty of rest and fluids, he added.
“If they develop a severe fever and they also develop a significant cough and develop pneumonia-like symptoms, they should contact a doctor,” Anderson said.
Flu prevention includes getting an annual flu vaccine, washing their hands with warm water and soap, cover coughs and if they feel ill, not go to work or school, he added.
“Vaccines are not 100 percent effective, but vaccines and good personal hygiene are effective,” Anderson said.
“Typically it starts to peak in the middle of February,” Anderson said about the flu season. “Right now we’re in that sporadic phase.”