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Public Health: Outbreak of Whooping Cough in St. Lawrence County

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CANTON - An outbreak of pertussis (also known as whooping cough) has been identified in St. Lawrence County.

Eleven cases have been confirmed throughout the area.

Active Public Health surveillance continues in the county to identify any additional cases so needed interventions are completed and the spread of disease stopped.

Pertussis, also called whooping cough, is a bacterial infection of the respiratory tract that can easily spread in droplets from an infected person sneezing or coughing into the air or onto objects. Pertussis may begin with coldlike symptoms and a mild cough which in 1-2 two weeks progresses to severe and prolonged coughing attacks, followed by a high pitched whoop. The coughing may be worse at night. Pertussis can be a serious illness and other complications may occur, especially with infants and young children. The cough can last several weeks or even months.

Individuals can get pertussis at any age. Those at highest risk include very young children and those who are not yet fully vaccinated. Adolescents and adults, because of waning protection from vaccines, often get pertussis and transmit it to children.

People who are exposed to the pertussis bacteria can experience symptoms in 7 to 10 days, but these can occur as early as four days and as late as 21 days. If untreated, an infected person can spread pertussis from onset of symptoms to thre weeks after the start of coughing.

Early administration of antibiotics, such as Z-pack or Bactrim for 5–14 days to those who are already sick can help them get well faster and lower the chances of spreading the disease to others. Anyone who has direct contact with someone having pertussis should receive preventive treatment, or prophylaxis, with a proper antibiotic to help protect against the infection.

The best protection against pertussis is vaccination as it is one of the vaccine-preventable diseases.

The Current Recommendations for Tdap vaccination are:

■ Among adolescents who have completed their childhood pertussis vaccinations, Tdap is routinely recommended as a single dose with preferred administration at 11 to 12 years of age. Tdap vaccine is required for school attendance by NYS Public Health Law. This includes grades 6 through 9 for the 2013-14 school year.

■ If an adolescent patient was not fully vaccinated for pertussis as a child or to meet school requirements, check the ACIP recommendations and catch-up schedule to determine what’s indicated. ACIP recommended in October 2010 to allow children ages 7 to 10 years who are under-immunized against pertussis or for whom vaccination status isn’t known to receive a dose of the Tdap vaccine.

■ Any adult 19 years and older who has not received a dose of Tdap should get one. This can replace one of the 10-year Td booster doses.

■ In October 2010, ACIP recommended permitting people older than 64 who have contact with infants younger than 12 months to receive a Tdap dose and allowing those older than 64 who haven’t received the Tdap vaccine to receive Tdap in place of the Td vaccine.

■ It is not necessary to wait the typical 10 years to get the adult dose of Tdap after the last dose of Td. In October 2010, ACIP recommended the removal of language in the current recommendations about suggested intervals between receiving the tetanus-diphtheria (Td) vaccine and the tetanus, diphtheria, and pertussis (Tdap) vaccine so that there would no longer be a minimum interval.

■ Women should get adult tetanus, diphtheria and acellular pertussis vaccine (Tdap) during each pregnancy. Ideally, the vaccine should be given between 27 and 36 weeks of pregnancy. Keep in mind that Tdap is not just for moms, it’s for all family members and caregivers of the infant.

■ Healthcare personnel who work in hospitals or ambulatory care settings and have direct patient contact should receive a single dose of Tdap as soon as feasible. Priority should be given to vaccination of healthcare personnel who have direct contact with infants 12 months of age and younger.

■ Tdap is preferred to Td for adults vaccinated more than 5 years earlier who require a tetanus toxoid-containing vaccine as part of wound management. Adults aged 19 years and older who require a tetanus toxoid-containing vaccine as part of wound management should receive Tdap instead of Td if they have not previously received Tdap.

Diphtheria, tetanus and pertussis vaccines are available as DTaP for infants and children through age 6 and Tdap for adolescents and adults ages 10 and older.

The vaccination protocol includes:

1 dose of DTaP at ages 2, 4, and 6 months.

1 dose of DTaP at age 15-18 months.

1 booster of DTaP at age 4-6 years, before entry to school.

1 booster of Tdap at age 11-12 years, before entry to sixth grade.

1 booster of Tdap, as a substitute for a Td (Tetanus, Diphtheria) booster at age 19 years and older for those who have not previously received a dose; then boost with Td every 10 years.

More information about pertussis is available on the New York State Department of Health and U.S. Centers for Disease Control websites. Information can also be found by visiting the St. Lawrence County Public Health Department webpage.

For additional information about pertussis and obtaining vaccinations, please call the St. Lawrence County Public Health Department at 386-2325, or contact your primary care provider.

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