Lingering outbreak of pertussis in four Chicago-area counties

Jun 20 2004

Due to a lingering outbreak of pertussis in four Chicago-area counties, Dr. Eric E. Whitaker, state public health director, today urged parents to ensure their children have been properly immunized against this highly contagious disease and asked that persons exhibiting symptoms to immediately seek medical care.

Since March, at least 69 people have been sickened by pertussis, commonly known as whopping cough, in Cook, Kane, Lake and McHenry counties. There have been no deaths.

Cases have ranged in age from 2 years to 55 years, but 80 percent of those diagnosed with the bacterial disease are 10- to 15-years of age. This is the first documented outbreak of pertussis in the United States involving youths in the 10- to15-year-old age group.

“Anyone who has symptoms of pertussis and has had contact with a person with pertussis, should consult their healthcare provider,” Dr. Whitaker said. “The Department is working closely with local health departments in each of the four counties to investigate and to help control the outbreak.”

Dr. Whitaker called on doctors and other healthcare providers in northeastern Illinois to assist local health departments in controlling the outbreak by promptly reporting suspect cases. Those with pertussis and their close contacts should be treated with antibiotics.

The five-dose pertussis vaccine is recommended for every child beginning at 2 months of age. Other doses are given at 4, 6 and 15 months and a final dose at 4 to 6 years of age. The vaccine is given in the same shot with diphtheria and tetanus and is required for school attendance.

The vaccination provides protection when children are most susceptible to serious illness, but immunization begins to wane three to five years after the last shot. Protection can be completely gone 12 years after the final inoculation.

Despite immunization efforts, pertussis in the United States has increased 400 percent since 1980. In Illinois, during the past decade the number of cases has risen from 111 in 1994 to 320 in 2003.

Pertussis can be easily spread from person-to-person through coughing and sneezing. An infected person is contagious from just before the onset of symptoms until up to three weeks after symptoms start. Although it is generally not a severe disease for adults, it can be a serious illness and cause death, particularly among children younger than 1 year of age.

Symptoms usually appear five to 10 days after exposure, but can take as long as 21 days to develop. The first symptoms to appear are similar to a common cold – runny nose, sneezing, low-grade fever and a mild, occasional cough. The cough gradually becomes severe and, after one to two weeks, the patient has spasmodic bursts of numerous, rapid coughs.

The characteristic high-pitched “whoop” comes from breathing in after a coughing episode. During such an attack, the patient may turn blue, vomit and become exhausted. Between coughing attacks, the patient usually appears normal. Some patients do not have the whooping-type of cough and may only experience a persistent cough.

The attacks tend to increase in frequency for a couple weeks, remain at the same level for two to three weeks and then gradually decrease. Coughing can last 10 weeks or longer. Recovery is gradual and coughing episodes can recur with subsequent respiratory infections for months after the onset of pertussis.

http://www.idph.state.il.us