Whooping cough found in Steamboat

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— Pertussis, or "whooping cough," is not a disease of the past. Nationwide, it has been on the rise since the early 1980s. In Colorado, 1,088 cases have been reported in 2004. At the current rate, the state is headed for the highest number of pertussis cases since 1950.

A confirmed pertussis case in a 2-month-old infant was reported in Steamboat Springs in mid-December. This column will address questions we commonly hear at Northwest Colorado Visiting Nurse Association.

n What is pertussis and how is it spread? Pertussis is a human, bacterial infection spread by droplets from coughing, sneezing, talking and close contact. It is an infectious respiratory disease that begins like a cold but progresses into severe coughing fits with a "whoop" on inhalation. Complications may include severe dehydration, bacterial pneumonia, seizures and neurological problems. It spreads during the first three weeks of coughing and will often infect everyone in the household.

n Isn't pertussis solely a children's disease? No. In 2004, 218 Coloradoans between the ages of 15 and 39 were reported to have pertussis. It can be deadly in the very young, the very small and the already weak. Importantly, older children and adults who have a lingering cough may have undiagnosed pertussis and unknowingly spread the disease to younger children and infants, an age group more likely to suffer from complications.

n Is pertussis treatable? Appropriate antibiotics will shorten the period of communicability, so early recognition and treatment is essential to containing the spread in the community.

n Is there a vaccine for pertussis? There is a safe and effective vaccine called DTaP for children. The DTaP vaccine is estimated to be 80 percent effective after three doses. This immunization should be given in five doses at 2 months, 4 months, 6 months, and 15 to 18 months of age, and between 4 and 6 years of age.

The fifth booster dose is important because it decreases the risk of school-age children transmitting the disease to younger children. Infants with only one or two doses of the vaccine are particularly vulnerable to pertussis, because their immunity is not yet highly protective.

n Is the vaccine safe? Yes. In 1991, the pertussis vaccine was improved. DTaP is more effective than the former pertussis vaccine, DPT; adverse side effects (fever and other mild systemic events) occur less frequently. The most common side effects in today's vaccine are tenderness or redness at the shot site, fussiness and low-grade fever for a day. Serious reactions (which happen in less than one out of a million doses) to DTaP are so rare it is not known if they are caused by the vaccine at all.

n Can older children and adults get pertussis if they received all their vaccines? Yes. The vaccine is not 100 percent effective. Protection from pertussis wanes after three years, resulting in little or no protection after 5 to 10 years. State health data indicates a jump in reported pertussis cases in the 10- to 14-year-old age group.

No pertussis-containing vaccine is licensed for people age 7 and older, but one is expected soon.

The following steps are recommended for prevention:

Vaccinate. Infants and children should receive all their vaccinations on time. If you have concerns about any recommended vaccine, discuss them with your health care provider and educate yourself with credible sources of information. There is much misinformation on vaccines in the media. Two excellent sources of information are www.immunize.

org and www.cdphe.state.co.us/

dc/Epidemiology/Pertussis/index.html

Practice good habits. Wash your hands often, avoid touching your face, cover a cough or sneeze with your elbow, not hands.

Parents of infants should be cautious. Keep your infant away from persons who are ill or have chronic coughs, ask everyone who holds your baby to wash their hands first, limit your infant's exposure to public gatherings.

Don't share items that spread disease, such as food, water bottles and toothbrushes.

Consult a physician immediately if you or a family member suspects pertussis.

The most effective measure to control pertussis is to maintain the highest level of immunization in our children in the community. A choice to not vaccinate is a choice to get and spread the disease.

Janice Poirot, RN, is a Public Health nurse with Northwest Colorado Visiting Nurse Association.

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