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Whooping Cough (Pertussis) Reaching Epidemic Proportions


The CDC is reporting the highest increase in reported cases of Whooping Cough since 1959.  Nearly 18,000 cases have been reported thus far in 2012.  This is more than double the number of cases reported at this same time last year.  It is not clear why the sudden and drastic increase in the number of cases, but theories include better detection, diagnosis, and reporting of cases, an evolution of the bacteria causing the disease, and potentially an issue with the effectiveness of the vaccine.

Whooping cough, or pertussis, is a highly contagious disease that can strike people of any age but is most dangerous to children.  So far nine children have died from the infection, most of those being under one year of age.  Its name comes from the sound children make as they gasp for breath.  In a healthcare environment, Pertussis is spread by means of respiratory/droplet infection.  Similar to TB, the same isolation procedures and use of N95 mask are required to protect health care workers and other patients.

It used to be a common threat, with hundreds of thousands of cases annually. Cases gradually dropped after a vaccine was introduced in the 1940s, and the disease came to be thought of as a relic of another age. For about 25 years, fewer than 5,000 cases were reported annually in the U.S. The numbers started to climb again in the 1990s.

The vaccine that had been given to young children for decades was replaced in the late 1990s following concerns about rashes, fevers and other side effects. While the new version is considered safer, it is possible it isn’t as effective long term, per Dr. Anne Schuchat, who oversees the CDC’s immunization and respiratory disease programs.

What's unusual is the fact that so many 13- and 14-year-olds are falling ill with the infection despite being fully vaccinated. The CDC is looking into whether this could be attributed to a change implemented in 1997 that saw the vaccine used to immunize children change from a version that was taken off the market in the U.S. because of possible neurologic side effects.

The current vaccination recommendations for healthcare workers from the CDC state:  A single dose of Tdap is recommended for health care personnel who have not previously received Tdap as an adult and who have direct patient contact. Tdap vaccination can protect health care personnel against pertussis and help reduce transmission to others. Priority should be given to vaccinating those who have direct contact with babies younger than 12 months of age.  Tdap can be administered regardless of interval since the previous Td dose. However, shorter intervals between Tdap and last Td may increase the risk of mild local reactogenicity.

The CDC’s biggest challenge right now is to get adults immunized.  In most reported cases, infants who contracted pertussis, were infected by an adult with the disease.  Of highest priority is pregnant women and new grandparents who will have exposure to infants and children. 

States with the highest number of outbreaks include Washington State, California, and Maryland.  Randstad Healthcare has seen a significant increase in the number of hospitals that are requiring Tdap vaccinations prior to any traveler/contractor starting an assignment at the hospital. 

For more information about the pertussis outbreaks, click on the following link: http://www.cdc.gov/vaccines/vpd-vac/pertussis/default.htm