As if cold, Covid, and flu were not enough to deal with in a college town, there is another illness spiking in Ann Arbor: pertussis. Pertussis, often known as whooping cough, is a highly contagious respiratory tract infection caused by the bacteria Bordetella Pertussis. Unfortunately, cases have been increasing across the country, and Michigan is no exception. As of the end of October, the cases of pertussis in Michigan are up over 30% compared to pre-pandemic levels. What does this mean in terms of numbers? This year, over 800 cases have been reported in Michigan; last year at this time, under 100 cases had been reported.
What are the symptoms of Pertussis:
The disease's scientific name, pertussis, comes from the Latin words per, meaning "intensive," and tussis, meaning "cough." Often, the early symptoms of pertussis can look like a common cold, with a runny nose, low-grade fever, and a mild cough. These symptoms can last for 1-2 weeks. It is not until later that people develop the uncontrollable “intensive cough,” often described as the worst cough of your life. Having had pertussis myself, I can attest to this description. Coughing can cause vomiting, fatigue, interfere with sleep, and even cause rib fractures. The classic whoop caused by the sharp inhalation of breath after a coughing fit may or may not be present.
You may be thinking to yourself, aren't we vaccinated against pertussis?
The answer is yes. But with declining rates of immunization across the state and normal waning immunity, we are seeing a rise in infections. To put things into perspective, prior to the vaccine becoming widely available in the 1940’s, pertussis was a leading cause of childhood illness and death in the United States. Thus, the concern about who is in charge of the Department of Health and Human Services really does matter.
Vaccination
The vaccine, which is very effective, is the best line of defense against pertussis. However, if pertussis is circulating in the community, there is still a possibility that even a fully vaccinated person could catch the disease. Infants who are too young to receive the vaccine are at high risk of becoming seriously ill. The vaccine for pertussis is a combination vaccine that also protects against diphtheria and tetanus (DTaP and Tdap).
The usual vaccine schedule is:
Infants and young children receive 5 doses of DTaP (from 2 months to 5 years).
Adolescents (11 to 12 years old) receive a single dose of Tdap.
Adults should receive booster doses of Tdap every 10 years to maintain protection. Yes, that means at 21, you need a booster.
Pregnant people should receive a single dose of Tdap between 27 and 36 weeks gestation during every pregnancy to provide protection for the baby.
When am I contagious?
People are contagious from the start of the illness when symptoms are often mild to up to 3 weeks after the onset of cough. It can take up to 5-10 days or longer for symptoms to appear after exposure.
How do we diagnose pertussis?
The diagnosis is made by having a high index of clinical suspicion and doing a nasal swab to send for PCR testing. Results are usually back in 24 hours.
What do you do if you have pertussis? Pertussis is treated with antibiotics. The most common medication prescribed is Azithromycin, which most people know as a Z-pack. If given early, antibiotics may shorten the course of illness. But remember, often pertussis is not diagnosed until later. In this case antibiotics do not help with symptoms, but help control the spread of disease. If you have pertussis, you should avoid group settings and activities until you have completed a full course of antibiotics.
What do you do if you have been exposed to pertussis?
The risk of catching pertussis from someone in your household can be as high as 80-90%. Close contacts should receive prophylactic antibiotic treatment with Azithromycin (or other appropriate antibiotic) within 3 weeks of exposure. Close contacts outside of the home should be considered for treatment on a case by case basis. If you think you may have pertussis or may have been exposed, you should see your doctor for testing and treatment. And remember to get vaccinated.
Whoop, there it is—everything you wanted to know about pertussis.
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