Tue09022014

Schools

Local students contract whooping cough

Some students in local classrooms have been diagnosed with pertussis – commonly known as whooping cough – in the past few weeks.

Whooping cough starts with symptoms similar to the common cold, including runny nose, congestion, sneezing, mild cough or fever. After one to two weeks, severe coughing can begin.

“All along we just thought it was a cold,” said one local parent, who asked to remain anonymous, of her daughter’s illness. “It wasn’t until she came home and said someone else in her class had whooping cough that we took her to the doctor.”

The parent said she let the illness go for a few weeks thinking it was just a cold. But when another of her children started to show symptoms and the school sent a cautionary letter to parents, she took her children to the doctor for a diagnosis.

“It kept lingering more than a normal cold,” the parent said of the illness. “Her cough was a stronger cough than an ordinary cold. The scary part of it is, when she is coughing, it doesn’t seem like she can catch her breath.”

The Santa Clara County Department of Health reported two cases of whooping cough from Los Altos, Los Altos Hills and Mountain View and seven cases in Santa Clara County over the past 45 days. While doctors are required to report pertussis, they don’t always make the report, so more recent cases may not have reached the county yet.

Joanna Lai, Bullis Charter School nurse, said there have been cases at the school in the past few weeks. Los Altos School District nurse Sarah Bolter said wasn’t aware of any cases in district schools, but parents are not required to report whooping cough.

Both Lai and Bolter said that if a classroom has more than one student with the same illness, then it is standard procedure to notify parents.

Symptoms and treatment

Charles Weiss, M.D., an urgent-care physician at the Palo Alto Medical Foundation, warned that pertussis is highly contagious, so recognizing the symptoms early is important.

He stressed that there are differences between a common cough and the whooping cough. If a cough has lasted for more than two weeks or the person coughing can’t stop, it is probably whooping cough, he said. It is common for people suffering from pertussis to make a “whoop,” a high-pitched sound when breathing in after a coughing attack. Adolescents are especially susceptible to whooping cough, Weiss added.

Weiss said schools act as incubators and the condition can spread quickly. He advised those who think they might have it to undergo testing and seek treatment. Students may return to school after five days of antibiotics. The antibiotics don’t necessarily relieve the cough, but they do decrease the contagiousness.

Unfortunately, the cough can persist, he said. An old Chinese description of the illness calls it the “100-day cough.”

“It is just miserable,” Weiss said. “It takes a lot of energy and tires you out. And no one wants to be around you.”

Diagnosing whooping cough in its early stages can decrease the length of the illness, he said.

Immunizations

Infants are immunized for whooping cough with the TDaP vaccine, a combination of tetanus, diphtheria and pertussis vaccines.

In the 1990s, the U.S. switched from a whole-cell pertussis vaccine to a combined acellular pertussis vaccine. The switch resulted in fewer immediate side effects from the vaccine but is now proving ineffective in protecting against whooping cough for as long a period, Weiss said.

“So in just the past few years, we are seeing that the vaccine is not as effective,” he said. “The immunity wanes within a couple of years. I estimate that boosters and vaccinations can run out within five years.”

Incoming seventh-graders are required to get the TDaP booster, but the recent cases are being diagnosed in students younger than that. A whooping cough outbreak occurred in Palo Alto earlier this year, with 114 cases reported from April through August.

“There is sort of a periodicity to pertussis,” Weiss said. “It tends to come back every three to five years. Our last big outbreak was in 2010.”

Contracting whooping cough is typically not serious unless the patient is pregnant or an infant.

Earlier this year, the California Department of Health reported the best way to prevent infants from contracting pertussis is to have their pregnant mothers vaccinated during the final stages of pregnancy.

For more information, visit cdph.ca.gov/HealthInfo/discond/Pages/Pertussis.aspx.

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