Whooping Cough Worst Year Since 1959, Says CDC, USA

Date: Jul-22-2012The United States is heading for the highest number of reported cases of pertussis (whooping cough) in fifty-three years, according to predictions by the Centers for Disease Control and Prevention. So far, nearly 18,000 cases have been reported this year; this is over double the total recorded for the same period in 2011. At this rate, 2012 will have the highest number of reported whooping cough cases since 1959.

Rear Admiral Anne Schuchat, M.D., Director of the National Center for Immunization and Respiratory Diseases, CDC, said:

"There is a lot of this out there, and there may be more coming to a place near you."

Washington state Secretary of Health, Mary Selecky, said that the number of pertussis cases in her state reached 2,520 by 16th June, 2012, and surpassed the 3,000-mark this week. The state declared an emergency in April this year. Washington Dept of Health says pertussis incidence is 1,300% higher now than during the first six months of last year.

Health authorities in the state of Wisconsin say there have been over 3,000 reported cases pertussis so far this year. Several other states, including New York, Kansas, Arizona, and Minnesota are also reporting significantly higher numbers compared to last year.
What is whooping cough (pertussis)?

Gram stain of the bacteria Bordetella pertussis, which causes pertussis (whooping cough)

Whooping cough, also known as pertussis, is a highly contagious bacterial infection of the lining of the airways caused by Bordetella pertussis. The infection mainly affects the trachea and the bronchi. The trachea is the windpipe, and the bronchi are the two airways that branch off from the trachea to the lungs.

The infection is transmitted from human-to-human through airborne droplets after coughing or sneezing. Babies and young children are usually the most at risk of infection, followed by teenagers and young adults.Early signs and symptoms of whooping cough are very similar to those of a cold, and may include a runny or blocked nose, a general feeling of malaise, a slight fever, sore throat, sneezing, watery eyes, and a dry and irritating cough.

Early whooping cough signs generally last for up to a couple of weeks, before getting worse.

More severe signs and symptoms - often referred to as the paroxysmal stage; is characterized by severe episodes of coughing. The patient may experience intense coughing which brings up thick phlegm, whoop sounds as the patient gasps for air, vomiting after bouts of coughing, fatigue, and redness in the face due to the intensity and duration of the coughing fits.

During a coughing bout the patient, usually a child, may cough non-stop for one or two minutes. Sometimes bouts may occur one after another and become a cluster of several minutes. A child may have up to 15 bouts or cluster bouts of coughing in one day.

During this stage, symptoms may last two weeks or more, and may persist even after treatment. The coughing may go on, even after Bordetella pertussis is no longer in the body.

Infants and very young children - there may be no whooping sound after the coughing, and the patient may gasp, gag, or even stop breathing. In some rare cases, it may become so severe that the child dies. Coughing fits may sometimes be accompanied with cyanosis (blue face) - in the vast majority of cases, the breathing resolves naturally with no harm occurring.

Paroxysmal symptoms of whooping cough are much less common and less severe in adults and older children.

The recovery stage can last several months, during which bouts of coughing may suddenly occur.
Whooping cough vaccinations
The best way to prevent pertussis is through the DTaP vaccination for infants and children and the Tdap for preteens, teenagers and adults. The childhood vaccine wanes after some years. Children get vaccinated in five doses, which start when the infant is 2 months old. The last dosage is given to young children when they are between 4 and 6 years old. A booster shot is given when the child is about 11.

The CDC urges parents and adults in general, especially pregnant mothers to get their shots so that they do not spread the disease to infants under the age of 2 months who are too young be vaccinated
Epidemiology of whooping cough
According to WHO (World Health Organization), about 48 million people are affected with pertussis each year, and nearly 295,000 die. Pertussis is one of the major causes of vaccine-preventable deaths globally. 90% of all cases occur in poorer nations, and predominantly among children and infants who have not been vaccinated. Vaccinated children are either protected from infection, or have much milder symptoms if they do develop whooping cough, compared to unvaccinated kids.

Before vaccinations were introduced in the 1940s, there were 157 cases per 100,000 persons in the USA, this figure dropped to 1 per 100,000 by 1970. The number of cases dropped from hundreds of thousands each year before the introduction of vaccines to single thousands and tens of thousands in a bad year.

Over the last twelve years, the number of reported cases of pertussis in the USA has been steadily increasing.

Written by Christian Nordqvist

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