A statewide surge in pertussis, commonly known as whooping cough, has officially hit Maricopa.
Marti Reich, infection prevention nurse at Cardon Children’s Medical Center in Mesa, said she’s “definitely seen an increase.”
“Here at Cardon we saw maybe four to six positive cultures in 2011 and we’ve seen 14 already to date in 2012,” Reich said.
“The majority are 2 months of age to under a year,” Reich said, explaining that infected infants often need to be hospitalized and sometimes treated in the ICU.
Although pertussis surges every three to five years as a general rule, according to the Centers for Disease Control and Prevention, the increase in reported cases both state and countywide is still notable for the rapidity in which it occurred and its continuing climb.
“There was a point when pertussis wasn’t even on the radar for a very long time,” Heather Murphy, Pinal County spokes woman for Pinal County, said.
But in 2010, the CDC reported a nationwide surge in the bacterial infection when 27,550 cases were reported. Statistics from the CDC for 2011 are due later this summer.
Statewide, the Arizona Department of Health Services reported 546 reported cases of whooping cough in 2011, up from 277 the previous year.
January through April this year the state health department reported 258 cases, according to the latest available statistics. Comparatively, during the same four months last year there were 145 cases.
“Pinal County has continued to see a spike in suspected and confirmed cases of pertussis throughout the county, particularly among adults and very young children,” Murphy said.
One local physician said he suspects people are not getting vaccinated.
“The thing about whooping cough is it’s largely a preventable disease,” said Dr. Paul Mikel, an obstetrician gynecologist at Banner Health Center in Maricopa.
Mikel said the number of pertussis cases has increased because “the frequency that people don’t vaccinate their children has finally caught up with us.”
Mikel said some mothers decline to vaccinate their child, hoping to “piggyback off the vaccinations of others.”
The problem with that, Mikel explained, is it works only if every other child the unvaccinated child came in contact with was vaccinated.
Reich added another cause may be adults not getting re-vaccinated for pertussis.
Since the immunity wears off over time, Reich pointed out “adults need a booster shot” approximately every 10 years.
Mikel said the decision not to vaccinate a child often was made out of fear or misconception about the vaccine, including that it is unsafe because certain preservatives — that have not been used for 30 years — cause autism or that it makes the vaccinated child contract the disease.
Those fears, Mikel said, are unfounded.
“The vaccines used at this health center, and at most health centers, are preservative free. They do not contain mercury or thymerzol,” Mikel said, adding that it is not a live vaccine and there is “no risk of the fetus developing autism.”
Tom Skinner, CDC spokesman, said the organization does not attribute the resurgence to lack of vaccination.
However, he said, his agency sometimes runs “into pockets, certain areas within the country, with a large population of unvaccinated people.”
Rather, he said the suspected cause was “waning immunity” for the young adults and adolescents, who are required to get a series of five vaccinations within six years.
However, Skinner stressed that studies were still being conducted and there were no definite answers as to the cause yet.Whooping cough can be difficult to diagnose.
The sickness begins looking like a cold, said Dr. John Seward, a pediatrician at Maricopa’s Banner Health Center.
In an older child, adolescent or adult, the infected person likely will suffer from two weeks of a runny nose and possibly a low fever.
But those fairly mild symptoms will be followed by “a prolonged cough; that’s the major difference,” Seward said.
In older children and adults, the cough is followed by a distinctive “whooping” sound, caused because the person coughing is unable to relax his or her chest muscles properly after a coughing fit.
“Once you hear (the cough), you never forget it,” Seward said.
That is usually the time people decide to see a doctor.
“The majority of adolescents and adults — when it’s most contagious — don’t usually come to the clinic until the cough won’t go away,” said Marion Levett, nurse at Sun Life Family Center in Maricopa. “By that time, a diagnosis can be made, but we might miss it because it’s bronchitis-like symptoms.”
Pertussis is usually confirmed through a nasal swab test.
Infants are at the highest risk of dying from pertussis. The CDC reported 10 infant deaths from the disease in California in 2010.
Not only do infants not make the distinctive sound, but they have a harder time fighting the disease. Often, they will turn a dusky, bluish color (as a result of not having enough oxygen) suffer from sleep apnea, gagging and possibly vomiting due to difficulties breathing.
For that reason, it is highly recommended that expectant mothers get a Tdap vaccine at the beginning of their third trimester as some of the immunity can be passed on to the unborn child.
“Most infants who die from it contract it from their mother,” Seward said.
Cocooning is a step family members and caretakers can take to avoid exposing an infant to the disease. It’s when every person likely to come in contact with the child gets vaccinated prior to its arrival into the home.
“The thing about pertussis is its spread though (coughing) droplets,” Reich, of Cardon Children’s Hospital, said. “So washing your hands is always a good idea, but it doesn’t really protect the child from someone coughing in the vicinity.”