KING COUNTY, WASHINGTON - Today, Public Health - Seattle & King County is reporting the highest number of infant pertussis cases in over 25 years. Overall this year, there have been 189 pertussis cases to date, and 28 of these cases have been among infants less than seven months of age. By comparison, last year at this time there were 10 pertussis cases among infants in this age group.
"Immunization of children is the best way to prevent pertussis and avoid serious complications," said Dr. Alonzo Plough, Director of Public Health - Seattle & King County. "As a general rule, all people with cough illnesses should take preventive steps like covering their mouths when coughing or sneezing, washing their hands frequently, and avoiding contact with infants and expectant mothers."
Thirteen of the 28 infants with pertussis were hospitalized, and none has died of the disease. Of the children ages two to seven with pertussis, nearly one third (6 out of 21 cases) was not immunized against the disease. Unimmunized children provide a reservoir of persons who can spread the infection to others in the family and community.
"Young infants are at high risk for serious illness and complications from pertussis. We need to increase efforts to prevent pertussis transmission in families and the community," said Dr. Jeff Duchin, Chief of Public Health's Communicable Disease Control, Epidemiology and Immunization Section.
Cases among adolescents and adults have also increased compared to recent years. Additionally, seven of the 28 infant cases are among Hispanic/Latino infants (25%), mirroring a national trend in which Hispanic/Latino infants are over-represented among infant pertussis cases. Public Health is currently collaborating on a multi-site Centers for Disease Control and Prevention study to learn more about the risk factors for infant pertussis.
Pertussis vaccination
"The pertussis vaccine protects the most vulnerable children against severe infection and death from the disease. Infants and children under seven years of age should be immunized against pertussis on schedule," said Duchin.
Pertussis vaccine is given as the combination diphtheria-tetanus-acellular pertussis (DTaP) vaccine series and is recommended for all children beginning at two months of age. Children under the age of seven years can be immunized with DTaP; the vaccine is not available for older ages.
While older infants and toddlers may have cough episodes that are typical of pertussis, very young infants may have less specific symptoms. This may delay the recognition of pertussis as the cause of the baby's illness. To help identify pertussis promptly, Public Health recommends informing the health care provider whenever a sick child or infant has been in contact with persons with a cough illness.
In addition to serious disease in infants, pertussis can cause a prolonged cough illness lasting for weeks to months in adults with complications including rib fractures and vomiting. Adults and older children with pertussis sometimes have a milder form of the disease that may not be recognized as pertussis.
"The pertussis vaccine prevents serious complications and death, but early recognition and treatment of persons with pertussis and their close contacts and keeping sick people away from infants are important to further reduce the total number of pertussis cases in the community," said Duchin.
Additional preventive steps
Pertussis is transmitted when infected persons cough or sneeze near, or touch, others. Although pertussis vaccine is the most important step in preventing severe infections among infants, additional important steps can reduce transmission of pertussis. These include:
- Prompt medical evaluation of infants with respiratory infections
- Persons with a cough illness that has lasted two weeks or longer or who have had contact with someone with pertussis should see a health care provider to be evaluated for pertussis.
- Persons treated for pertussis should remain at home and avoid contact with others until five days after initiation of appropriate therapy.
- All persons with cough illnesses should take extra care to avoid contact with infants and expectant mothers, including visiting or working in labor and delivery as well as nursery areas of hospitals and in child day care settings.
- Adults and children should avoid sharing with infants food, toys, or other objects likely to have been contaminated with respiratory secretions.
- Persons with cough illnesses should cover their mouth and nose when coughing and sneezing and wash hands thoroughly before touching others and items shared with other persons.
- Hands that are soiled with respiratory secretions should be washed immediately with soap and running water. As an alternative, an alcohol-based, waterless hand sanitizer may be used.
- Hands should be washed thoroughly before handling or preparing food for an infant.
Updated detailed information and recommendations for health care providers have been posted on the Public Health website: www.metrokc.gov/health/providers
For more information on pertussis, call Public Health - Seattle & King County's Communicable Disease Control, Epidemiology and Immunization Section at 206-296-4774, or visit:
