It can start out innocent and mimic symptoms of the common cold or bronchitis, but if the cough lasts longer than 14 days, there's a possibility that it could be pertussis, commonly known as whooping cough.
In response to the increased number of whooping cough cases in North Dakota, First District Health Unit in Minot will hold a Tdap (tetanus, diphtheria and pertussis) clinic on Thursday, Aug.16, from noon until 6:30 p.m. No appointment is necessary for this clinic. Cost for the Tdap vaccine will depend on if the person is insured and if their insurance covers vaccines, while uninsured children can receive the vaccine for $13.90 through the Vaccines For Children program, explained Melissa Fettig, immunization coordinator and registered nurse for First District Health Unit. People coming to the Tdap clinic are encouraged to bring their insurance card and immunization record.
The Tdap vaccine is recommended by the Centers for Disease Control and Prevention for children entering middle school and is required to attend middle school in North Dakota, Fettig said. People who have not received one dose of Tdap as an adult should get one dose now, she added, and wants to encourage people who are not up-to-date with their immunizations to come to the clinic.
There are fairly normal side effects to the Tdap shot, Fettig noted. She said there's usually mild pain and redness at the injection site and some people experience muscle stiffness, but it usually resolves within 24 to 48 hours. "We want babies to get the vaccine, but we also want people who have contact with babies," Fettig remarked. "The most high-risk for pertussis are children 12 months and younger who haven't been vaccinated yet."
The increase in cases of whooping cough is much more drastic in other states, Fettig said. "The best thing is to get vaccinated now," she added. "Don't wait until there's a big outbreak." The upcoming Tdap clinic will give access to the community to prevent large outbreaks of whooping cough, Fettig remarked.
For people who are unsure if they've had the Tdap vaccine, Fettig said they should check with who they received immunization from and to be clear about whether they've had a Td or Tdap shot because they're different. Just the Td shot does not protect you against pertussis, she said, only against tetanus and diphtheria.
Pertussis is the most severe in infants and small children, Fettig noted, and they're the most at-risk for developing complications requiring hospitalization. "Over half of infants under 1 year who get whooping cough require hospitalization," she added. Everyone is at risk, though, Fettig noted, but babies and young children are especially at risk.
Symptoms of whooping cough start out like the common cold with a cough that slowly gets worse, developing into uncontrollable coughing spells, Fettig explained. The "whoop" noise heard when coughing is the tell-tale sign in children, but symptoms in adults can vary and mimic the common cold, she continued.
Bacteria cause pertussis and the diseases is very contagious, Fettig said. It's spread through coughs, sneezes, or when the infected person talks, she added. "It's so contagious because it makes you cough so much," Fettig noted. People are contagious with pertussis from the onset of cold-like symptoms until three weeks after cough onset, she also said.
Whooping cough is diagnosed by a health-care provider who will collect a sample of mucus from the back of the nose, then laboratory tests are performed on the sample, according the North Dakota Department of Health's website. It can be difficult to diagnose in adolescents and adults without laboratory testing because the disease can mimic bronchitis in those age groups. "That's the biggest reason it's underdiagnosed," said Fettig. "The distinguishing characteristic is a cough lasting longer than 14 days."
The treatment for whooping cough is with an antibiotic, which helps to prevent transmission of the disease to others and may possibly reduce the severity of the disease if given early in the disease's course, the website explained. Those treated with antibiotics are contagious until five days of treatment are completed and anyone who is exposed to whooping cough should also be given antibiotics to prevent themselves from being contagious if they develop the disease, even if they were vaccinated, the website also said.
People who have had pertussis can get it again, Fettig said, so it's important to get vaccinated. Also, people who have pertussis should be excluded from activities and work until five days of antibiotic treatment have been completed, the Department of Health website added.
Some ways in which people can try to avoid getting whooping cough are to rest, drink plenty of liquids, wash your hands often, and get the Tdap vaccine, Fettig said. "And when you're sick, stay home," she also said. "I can't emphasize that enough."
There are two vaccines that protect against pertussis, both of which also protect against diphtheria and tetanus, the North Dakota Department of Health's website said. The childhood vaccine is the DTaP and the vaccine for older children, adolescents, and adults is called Tdap, and typically, children under the age of 6 will receive five doses of DTaP, the website continued.
Whooping cough has always been here and there will always be cases of it, Fettig noted. There were 90 cases whooping cough as of last Friday, up from 70 reported in 2011, according to the North Dakota Department of Health. Pertussis outbreaks are cyclic, Fettig noted, and scientists don't know why. Not completing the DTaP series in children increases the spread of pertussis, she added. "Parents should be aware that if children have not received the full series of DTaP shots, they may not be fully protected against pertussis."