The Minnesota Department of Health and local health care providers are hoping the new year will bring a drop in cases of pertussis, also known as whooping cough, after hitting the highest number of cases in 75 years in 2012.
As of Thursday, Dec. 27, Wright County had the sixth-highest number of reported or suspected cases of the illness – 282 – out of the 4,433 total cases statewide. That is up 133 cases in less than a week. The highest numbers in Minnesota are found in Hennepin County, 1,091, followed by Anoka, 503, Washington, 328, Ramsey, 285 and Dakota, 284.
Pertussis is spread from person to person through the air. It can cause a severe cough lasting four to six weeks or longer. MDH epidemiologist Cynthia Kenyon says that while the state has recorded more than 4,433 cases of pertussis this year, the actual number is higher.
"Pertussis can be really hard to identify, especially in older adolescents and adults, where sometimes it can be very mild and people might not think that it’s pertussis," she said.
The last time the state had this large an outbreak of whooping cough was in 1937, when the total reached 4,851 cases. Nationally, the pertussis figure is the largest it has been in more than a half century.
Annandale cases are up
In Annandale, Allina Clinic manager Rebecca Fischer, said the prevalence of the illness locally is consistent with reports coming from the county and the state in terms of the increased number of pertussis cases.
"Yes, we are seeing it in our clinic so we’re trying to test as much as we possibly can," Fischer said. "I know we were seeing it in November."
Fischer said they are seeing much more of it this year than the previous year.
"I want to say it’s at least doubled at a minimum," she said, adding that the highest incident rate has been in the 10- to 13-year-old age group.
"We’re seeing a lot of 10-year-olds with it," Fischer said. "That is what we’re hearing, that it’s higher in the 10-13 age group because the vaccine has worn off from when they were younger."
According to the MDH, that may be because that age group was among some of the first children to receive a new pertussis vaccine in 2008.
"The two vaccines are just as good, but the newer vaccine wanes earlier, so it doesn’t last as long," Kenyon said. "And we switched to that newer vaccine because it had a better safety profile."
Containing the outbreak
Fischer is hoping the holiday break will slow down the exposure rates with kids not being around each other at school every day.
"We’re hoping, we’re really hoping it helps," Fischer said. "Before the holidays we even had teachers coming in and getting checked, which is good."
One of the challenges, according to Fischer, is that it can take up to three weeks before a child or adult knows they have it and it doesn’t always show up when testing in the early stages. For that reason, many practitioners are treating anyone who is displaying symptoms.
"The other thing is that if people have one child with it, make sure you tell your (health care) provider that others have been exposed because otherwise you may have a kid in the same family that’s been exposed but doesn’t know they have it so they go to school for another five days and expose even more kids," Fischer said. "That’s the problem we’re having with getting it under control. We’re trying to get ahead of it, that’s for sure."
In late September, the MDH updated its vaccination recommendations related to pertussis. In bulletin issued by the MDH, it says, "MDH recommends statewide vaccination of children starting at age 10 years, regardless of whether the child is from an area of high incidence. This change is due to persistently high incidence of pertussis disease in children ages 9 to 12 years."
MDH is also recommending that practitioners give Tdap to children as early as age 10 years "who present in clinic," but a child who receives a dose at age 10 does not need another at ages 11 or 12 years.
More information is available about immunizations and what to do before or after coming down with whooping cough at www.health.state.mn.us.