Minnesota and ND whooping cough cases spike, mirroring national trend

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Minnesota whooping cough
• North Dakota whooping cough

North Dakota whooping cough
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• Doctors ‘very concerned’ about rise in whooping cough cases

Minnesota health officials are expecting an unprecedented number of whooping cough cases this year, if the current trend holds. Minnesota Department of Health immunization director Kris Ehresmann says by the end of the year, whooping cough cases could top 3400. That would double the last outbreak in 2005.

North Dakota health officials also are seeing a spike in cases of whooping cough, said Abbi Pierce, immunization surveillance coordinator in the Division of Disease Control, North Dakota Department of Health.

So far this year, North Dakota has more cases of whooping cough than were reported in all of 2011. As of July 23, the health department has received reports of 79 cases, already surpassing last year’s total of 70.

Both states are in sync with the national trend of sharply escalating numbers of whooping cough cases that is causing serious concern among health care professionals.

Throughout the U.S., nearly 18,000 cases have been reported so far this year, more than twice the number seen at this point last year, the Centers for Disease Control and Prevention said recently.

50-year high

At this pace, the number for the entire year will be the highest since 1959, when 40,000 illnesses were reported, according to the CDC.

“Several states are reporting incredibly high numbers of cases this year,” Pierce said.

In North Dakota, “we’re experiencing higher levels of cases but nowhere near the levels they’re seeing in Minnesota and Washington,” she said.

North Dakota’s highest number of whooping cough cases, 757, was recorded in 2004, Pierce said.

In the population as a whole, the disease waxes and wanes, said Dr. Gregory Poland, professor of medicine and infectious diseases at Mayo Clinic in Rochester, Minn. “Numbers of cases go up every three years or so. No one knows why.”

The phenomenon may be due to “periodicity,” he said, the timeframe when there are enough children who are susceptible to the disease because, as they age, the vaccine loses effectiveness.

Cold-like symptoms

Whooping cough, also known as pertussis, strikes the respiratory system and typically starts with cold-like symptoms that can include a runny nose, congestion, fever and a mild cough.

The CDC advises parents to see a doctor if they or their children develop a prolonged or severe cough.

Whooping cough is treated with antibiotics, the earlier the better.

“The first line of defense is prevention,” said Poland, who is also director of the Mayo Vaccine Research Group.

He recommends that anyone who’s experiencing a persistent, unusual cough go in to see a doctor or health professional right away.

Unreported cases

Many cases of whooping cough are undiagnosed or misdiagnosed, Pierce said. Those who are infected may unknowingly spread the disease.

“People have symptoms, like a nagging cough that won’t go away, and it may be diagnosed as bronchitis… It goes away on its own.

“They may have no complications,” she said. “A lot of people don’t seek health care.”

People usually spread pertussis by coughing or sneezing while in close contact with others, who then breathe in bacteria that cause whooping cough.

A young child or baby who becomes infected exhibits more classic symptoms, and that’s when the disease is diagnosed, Pierce said.

“Unfortunately, the youngest are the ones who have the most severe consequences.”

Babies younger than three months have little, if any, immunity to the cough, but cannot be vaccinated until they are older. Infants younger than six months represent almost 90 percent of all pertussis deaths.

The pertussis vaccine is usually given at two months, said Dr. James Hargreaves, infectious disease specialist with Altru Health System in Grand Forks. “If given earlier than that, it doesn’t work very well.”

So far this year, nine children have died in the U.S., the CDC said recently. Last year, 14 victims died; in 2010 there were 27 deaths.

A vast majority of whooping cough cases that have been reported this year in North Dakota, about 80 percent, are children younger than 18, Pierce said.

Get vaccinated

There are two vaccines for whooping cough, one for children as old as 7, and another for anyone older.

The North Dakota health department encourages parents of children who are entering school to get their kids vaccinated with DTaP (diphtheria, tetanus and acellular pertussis). Adolescents and adults should get the Tdap (tetanus, diphtheria and pertussis) vaccine.

Pregnant women are advised to get vaccinated to protect the newborn from contracting the disease.

“Anyone is recommended to get a dose” of the vaccine, Pierce said, “especially if you have grandkids or are around kids a lot.”

Flu season is coming up, she said. “When you see your doctor for a flu shot, ask what other vaccinations you should have.

“It’s important, especially for those younger ones who suffer greatly when they get pertussis.”

Whooping cough

• highly contagious bacterial disease

• patients make a “whooping” noise as they gasp for breath

• coughing fits can lead to vomiting or even short losses of consciousness

• infants can have spells of choking with whooping cough

• strikes people of any age but is most dangerous to children

• children should get five shots, starting at 2 months and the last one when child is 4 to 6 years old

• a booster shot is recommended at age 11 or 12

Source: National Library of Medicine and the Centers for Disease Control and Prevention

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