Your children’s health: preventing and addressing pertussis
December 15, 2014 -
According to the Centers for Disease Control and Prevention
(CDC), whooping cough (pertussis) is cyclical, peaking every three to
five years. Since the 1980s, the number of reported pertussis cases has
gradually increased in the United States. In 2005, more than 25,000
cases of pertussis were reported throughout the nation, the highest
number since 1959.
For some states, there has been a spike in pertussis
cases recently. For example, as of December 2014, the number of cases in
California is five times greater than baseline levels, prompting the
state to declare a pertussis epidemic, with infants affected most
significantly. In 2012, New York was ranked third highest in the United
States for pertussis.
Several factors are thought to be affecting the
uptick in cases: waning immunity, increasing numbers of unvaccinated
children and adults and improved awareness of the resurgence of
pertussis, leading to improved reporting and diagnosis.
Pertussis is a highly contagious disease that is
spread through the air by cough. It begins with cold symptoms and a
cough that can worsen within one to two weeks. According to the New York
State Department of Health, pertussis can lead to prolonged
hospitalizations and be particularly dangerous for infants.
Pertussis can affect people at any age. Children who
are too young to be fully vaccinated (vaccinations typically begin at
two months of age) and those who have not yet completed the series of
vaccines are at highest risk for severe illness. Infants — especially
those younger than six months — are most likely to have severe symptoms
if they develop pertussis. When possible, young infants should be kept
away from people with a cough.
Children who have been around someone with pertussis
could become sick, even if their shots are up to date.
Symptoms of pertussis
Pertussis symptoms usually include a long series of
coughs (“coughing fits”) followed by a whooping noise. However, older
children, adults and very young infants might not develop the whooping
sound. The cough is often worse at night and cough medicines usually do
not help alleviate it.
Other symptoms of pertussis include a slight fever,
vomiting, turning blue or difficulty breathing.
Major complications of pertussis are more common
among infants and young children and could include pneumonia, middle-ear
infection, loss of appetite and sleep disturbances.
Parents who suspect their child has been exposed to
someone with pertussis should contact their family physician.
Antibiotics might prevent the child from becoming ill. If the child is
already sick, giving antibiotics early can help shorten the duration of
the illness and lessen the chances of the disease being spread to
If untreated, a person can transmit pertussis from
the onset of symptoms to three weeks after the onset of coughing
episodes. The period of communicability is reduced to five days after
treatment with antibiotics.
Notifying others of illness
According to the CDC, if a child is diagnosed with
pertussis by his or her doctor, parents should notify the child’s
School nurses then call their local health
departments to verify that the student has, indeed, been diagnosed with
pertussis. Health officials are careful not to report suspected cases,
only reacting to cases that have been formally diagnosed with a lab
Once doctors diagnose pertussis, they also are
required to report it to their county health departments. County health
departments, however, also receive notification through the New York
State Electronic Laboratory System, to which the State Department of
Health also is connected.
Once a case has been confirmed, the child’s school
alerts parents of children who have been in contact with the affected
student. Privacy laws, however, prohibit the school from releasing any
information that would reveal the identity of the sick student. Letters
home, therefore, likely will only state which building or grade level
the child is in.
County health departments often work with the doctor
to follow up with the family to make sure the proper care is being
carried out and do what they call “contact tracing,” or notifying those
who might have been exposed to the disease.
If parents been notified their child has been exposed
to someone infected with pertussis, they should watch for symptoms,
county health officials said. Visit the doctor if a child starts to
exhibit cold-like symptoms and a mild cough or fever.
Preventing pertussis with vaccinations
According to the CDC, neither vaccination nor natural
infection with pertussis guarantees lifelong protective immunity against
the disease. Because immunity decreases after five to 10 years from the
last pertussis vaccine dose, older children, adolescents and adults are
at risk of becoming infected.
However, vaccination is the best protection against
the disease and the number of cases is still far fewer than before
vaccines became available. The CDC recommends getting all children and
adults fully vaccinated against pertussis.
In New York state, students attending school are
required to have four to five pertussis vaccinations to enter
kindergarten, and those born after 1994 would need to receive a booster
before entering sixth grade. See
http://www.health.ny.gov/publications/2370.pdf for specific vaccination
Other prevention tips
Pertussis is transmitted by coughing and sneezing
while in close contact with others, so good hygiene helps prevent the
illness from spreading. Parents can:
• Remind children to cover their noses with a tissue
when they cough or sneeze and throw away used tissues.
• Have children wash hands frequently with soap and water for at least
• Disinfect frequently touched surfaces and shared items at least once
• Keep children at home if they are coughing, sneezing or have low-grade
CDC’s pertussis homepage:
Fact sheet on pertussis from the NYS Health