Whooping cough not just a disease for kids

WILLMAR -- Local medical providers are stepping up their efforts to fend off an old infectious enemy -- whooping cough.

Whooping cough, or pertussis, has traditionally been regarded as a childhood disease. But teenagers and adults can get sick from it too, and often they spread it to younger, more vulnerable children as well. That's why booster doses of vaccine are now being recommended for teenagers -- as well as for many adults, especially those who spend time around very young children or who have certain health risks such as asthma, emphysema or immune-system problems.

"We're trying to be more aggressive about it as people are coming in for visits," said Stacey Zondervan, patient services supervisor at Family Practice Medical Center of Willmar.

If you think whooping cough is a disease of the past, think again.

The bacterium that causes it, Bordetella pertussis, has never been completely eradicated. In recent years, health officials have seen the disease make a comeback as vaccine protection wanes among adolescents and adults.

In Minnesota, 2005 was a peak year for whooping cough, with more than 1,500 reported cases.

Closer to home, outbreaks occurred in 1998 in Dawson and Boyd and in 1999 in Meeker County.

"We've seen a significant amount of whooping cough in southwest Minnesota. We've had providers who have acquired whooping cough," said Jo DeBruycker of the Health Learning Center at Affiliated Community Medical Centers.

"Certainly whooping cough is out in the community," Zondervan agreed. "It's one of those illnesses you just continue to see. When you look at all the diseases we immunize against, I don't remember ever seeing a case of polio. But pertussis kind of floats along yet."

Pertussis bacteria are spread through respiratory droplets. Early symptoms are similar to the common cold -- low-grade fever, runny nose and cough.

Then severe coughing sets in, sometimes lasting six weeks or longer. The coughing, which may or may not be accompanied by a characteristic whooping sound, often is severe enough to cause vomiting.

Teenagers and adults who get whooping cough might be sick enough to stay home from school or work.

Infants, however, can become the sickest, especially those who are too young to be fully immunized yet. Often they must be hospitalized, and they can develop complications such as respiratory distress, dehydration and pneumonia. Rarely, whooping cough can be fatal.

Zondervan said it's important for babies and toddlers to receive their immunizations on time.

The pertussis vaccine is usually given in five doses before the age of 6. Typically it's combined with a diphtheria and tetanus vaccine.

But because the pertussis vaccine wears off by age 11 or 12, booster shots also are now recommended at this age.

Among adults, the U.S. Centers for Disease Control and Prevention recommends a booster dose of pertussis vaccine for anyone in close contact with infants under the age of 1. A booster shot also is urged for adults who have respiratory diseases such as asthma or emphysema, or a weakened immune system.

Adults transmit whooping cough to children more commonly than the public might think, DeBruycker said.

Last year Affiliated Community Medical Centers gave pertussis boosters to all its employees to prevent exposure to vulnerable infants and toddlers, she said.

"If you have any contact with little ones, you have to think about it," she said. "The severity of the disease is much greater with them. It's a good time to talk to your doctor about it."

There's "no hard and fast rule" for when adults should receive a pertussis booster, she said. Most often, it's administered in a combined dose with a tetanus booster when it's time for the patient to update his or her tetanus protection.

If more adolescents and adults are fully immunized against whooping cough, there's a better chance of lowering the number of cases that occur each year, Zondervan said. "That would be the hope."

The Minnesota Academy of Family Physicians last month began urging the public to be more aware of whooping cough and to see a doctor if they're having severe coughing episodes or have been exposed to someone with pertussis.

Because the symptoms are similar to a wide range of respiratory illness, people can overlook the possibility of whooping cough, DeBruycker said.

"It's so easy to be blinded," she said. "You always have to have it in the back of your mind."