2013 About Pertussis (Whooping Cough)

Transcription

1 2013 About Pertussis (Whooping Cough) Pertussis Pertussis, also known as whooping cough, is a highly contagious and often serious disease, especially in young children. 1,2 In adolescents and adults it usually presents as a severe cough that may last for weeks and even months. 1, 2 Pertussis is caused by bacteria called Bordetella pertussis, found in the mouth, nose and throat of the person with the disease. It is spread through contact with respiratory droplets generated when that person coughs or sneezes. 1,2,3 There are both severe and milder forms of pertussis. The milder form, which usually occurs in adults and older children, is often mistaken for the common cold or bronchitis and can be easily spread. Severe pertussis usually occurs in babies and young children, who are at higher risk for pertussis-related complications. 1,2 The best way to help prevent pertussis is timely vaccination with the recommended pertussis vaccines. Pertussis disease can be treated with antibiotics. If caught early enough, antibiotic treatment may help lessen disease severity. Antibiotic therapy also helps reduce transmission and is important for disease control. 4 Pertussis: On The Rise According to the U.S. Centers for Disease Control and Prevention (CDC), America is experiencing one of the largest outbreaks of reported pertussis cases in approximately 50 years. 5 In the last decade ( ), the total number of pertussis cases reported to the CDC was approximately 150 percent higher than the total number of cases reported during the 1990s. 5 While pertussis has historically followed a cyclical pattern with peaks in activity seen every three to five years, 6 the number of reported cases of pertussis in the United States has been steadily increasing since In 2012, the number of provisional cases reported to the CDC continued to rise. 8,9,10 As of January 10, 2013, 49 states and Washington, D.C. reported increases in pertussis cases in 2012 compared with

2 Pertussis Transmission Immunity from early childhood pertussis vaccinations wears off after about five to 10 years, leaving adults susceptible to the disease, which they can then transmit to others. 3 Researchers found that when it could be determined how an infant caught pertussis, family members were responsible for spreading the disease to the baby in up to 80 percent of cases. 12,13 More specifically, parents were responsible up to 50 percent of the time. 12,13 Schools and day care centers are common places where children can be exposed to pertussis. Up to 80 percent of unvaccinated children who are in school with someone who has pertussis will catch the disease. 14 For more information on how to help protect yourself and help stop the spread of pertussis to the important children in your life, visit SoundsOfPertussis.com Pertussis Prevention Immunization is the best way to help prevent pertussis. 15 The vaccine to help protect children against pertussis is combined with other components to create a DTaP (diphtheria, tetanus and acellular pertussis) vaccine. A DTaP vaccine should be administered in five doses: at 2 months, 4 months, 6 months, months of age and 4-6 years of age. It is very important that every child receives all five doses on time for maximum possible protection. 16 The vaccine to help protect adults and adolescents against pertussis is known as a tetanus, diphtheria and acellular pertussis (Tdap) booster vaccine. The CDC recommends adults and adolescents, especially those in contact with an infant, receive a single dose of Tdap vaccine. For the most recent recommendations, please visit: % of unvaccinated children living with someone with pertussis will contract the disease. 14 o If you re pregnant and have never had a pertussis booster vaccine, talk to your healthcare provider about the best time for you to receive a vaccine. 18 Pertussis In Adolescents and Adults Pertussis is often undiagnosed or misdiagnosed in adults, leading to vast underreporting of the disease. Estimates indicate that there may be as many as 800,000 to 3.3 million adult and adolescent cases of pertussis in the U.S. in any given year. 19 2

3 Estimates from the 2011 National Health Interview Survey (NHIS) show that only 12.5% of adults have reported receiving a Tdap booster vaccine, despite the CDC recommendations. 21 In studies of adults with pertussis, the majority of patients coughed for at least three weeks. 3 o Most adolescents and adults with pertussis are ill for several weeks and have several physician office visits before they are diagnosed. 3 o Adult pertussis symptoms are often milder than those found in infants and can resemble the common cold or bronchitis. 1,2 o Complications of pertussis include pneumonia, loss of consciousness, female urinary incontinence and rib fracture resulting from severe bouts of coughing. 20 Although vaccines play an important role in helping protect public health, many adults are behind on their immunizations, resulting in increased incidence of diseases such as pertussis. Pertussis In Infants and Children Pertussis is most dangerous for babies. More than half of babies younger than 1 year of age who get the disease must be hospitalized. 2 In 2012, more than 83 percent of pertussis deaths occurred in infants younger than 12 months of age. 22 Young infants are at highest risk for pertussis-associated complications. 20 o Pertussis can cause more severe and sometimes life-threatening complications in infants and young children. 2 o In some infants and children, pertussis causes severe coughing, which can be characterized by the unforgettable whoop sound made when gasping for air after a coughing fit. 2 The coughing fits can be so violent that vomiting often follows, and infants cannot catch their breath and may turn blue. 2 o Infants younger than 6 months of age may not have the strength to have a whoop, but they can experience apnea, which is a pause in the breathing pattern. 2 The National Immunization Survey conducted annually by the CDC from 2006 to 2010 consistently shows that 15 percent of children 19 to 36 months of age in the U.S. have not received their recommended 4th dose of DTaP vaccine. Delaying the 4th dose may leave the child vulnerable to pertussis. 23 ### 3

4 References: 1. Centers for Disease Control and Prevention (CDC). Disease Information: Pertussis: Causes & Transmission. Accessed March 21, 2. Centers for Disease Control and Prevention (CDC). Disease Information: Pertussis: Signs & Symptoms. Accessed March 21, 3. Kretsinger K, Broder KR, Cortese MM et al. Preventing tetanus, diphtheria, and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine recommendations of the Advisory Committee on Immunization Practices (ACIP) and recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for use of Tdap among health-care personnel. Morb Mortal Wkly Rep 2006; 55(RR-17): Accessed March 21, 4. Centers for Disease Control and Prevention (CDC). Nonfatal Bathroom Injuries Among Persons Aged > 15 Years United States, Morb Mortal Wkly Rep 2011;60(22): Accessed March 21, 5. Cherry, JD. Perspective: Epidemic pertussis in 2012 the resurgence of a vaccine-preventable disease. N Engl J Med. 2012; 367: August 30, Accessed March 21, 6. Centers for Disease Control and Prevention (CDC). Pertussis Outbreaks - Questions and Answers. Accessed April 8, 7. Centers for Disease Control and Prevention (CDC). Prevention of Pertussis, Tetanus, and Diphtheria Among Pregnant and Postpartum Women and Their Infants. Accessed April 8, 8. Centers for Disease Control and Prevention (CDC). Pertussis Surveillance & Reporting: U.S. reported pertussis incidence Accessed April 8, 9. Centers for Disease Control and Prevention (CDC). Violence-Related Firearm Deaths Among Residents of Metropolitan Areas and Cities United States, Morb Mortal Wkly Rep 2011;60(18): Accessed April 8, 10. Centers for Disease Control and Prevention (CDC). Sunburn and Sun Protective Behaviors Among Adults Aged Years United States, Morb Mortal Wkly Rep 2012;61(18): ND Accessed April 8, 11. Centers for Disease Control and Prevention (CDC). Pertussis Outbreak Trends. Accessed April 8, 12. Bisgard KM, Pascual FB, Ehresmann KR et al. Infant pertussis: who was the source? Pediatr Infect Dis J. 2004;23(11): Wendelboe AM, Njamkempo E, Bourillon A et al. Transmission of Bordetella pertussis to young infants. Pediatr Infect Dis J. 2007;26(4): Offit, P, Bell, L. Vaccines: What You Should Know; 3rd Ed. New Jersey: John Wiley & Sons, Inc.; Centers for Disease Control and Prevention (CDC). Pertussis (whooping cough). Accessed March 21, 16. Centers for Disease Control and Prevention (CDC). Disease Information: Pertussis: Prevention. Accessed March 21, Centers for Disease Control and Prevention (CDC). Immunization Schedules. Accessed March 21, 18. Centers for Disease Control and Prevention (CDC). Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine (Tdap) in Pregnant Women and Persons Who Have or Anticipate Having Close Contact with an Infant Aged <12 Months --- Advisory Committee on Immunization Practices (ACIP), Morb Mortal Wkly Rep 2011;60(41): Accessed March 21, 4

5 19. Cherry JD. The epidemiology of pertussis: a comparison of the epidemiology of the disease pertussis with the epidemiology of Bordetella pertussis infection. Pediatrics. 2005;115(5): Accessed March 21, 20. Centers for Disease Control and Prevention (CDC). Disease Information: Pertussis: Complications. Accessed March 21, 21. Centers for Disease Control and Prevention (CDC). Noninfluenza Vaccination Coverage Among Adults United States, Morb Mortal Wkly Rep 2013; 62(04); Accessed April 15, 22. Centers for Disease Control and Prevention (CDC) Provisional Pertussis Surveillance Report. Accessed April 1, 23. Centers for Disease Control and Prevention (CDC). National and State Vaccination Coverage Among Children Aged Months United States, 2010;60(34); Accessed March 21, 5