Whooping cough case reported in District 833's Lake Middle School
It's the time of year when many people find themselves fighting the common cold, but last week a case of whooping cough, or pertussis, was confirmed at District 833's Lake Middle School.
Since January of last year a total of 160 whooping cough cases have been reported, according to Fred Anderson, an epidemiologist with the Washington County Public Health & Environment Department.
Whooping cough is a respiratory illness that is caused by bacteria.
The incubation period for the bacteria is about 7-10 days, Anderson said.
The bacteria are frequently seen transmitted in household settings from family member to family member.
"Sometimes in school settings depending on the proximity of the infected person to the other person," Anderson said. "It depends on the frequency and prolonged exposure."
Whooping cough typically begins with symptoms similar to that of the early stage of a common cold, such as sneezing, runny nose, a low grade fever and a mild cough.
As the illness progresses, the cough worsens.
"It becomes an uncontrollable outburst of coughing," Anderson said.
Following the severe coughing, people with whooping cough will be seen trying to catch their breath.
The cough can be so severe that it can often result in vomiting, Anderson said.
Additionally, the cough is more prevalent at night.
People diagnosed with whooping cough are prescribed antibiotics for a five day period.
Whooping cough can be diagnosed through a nasal swab test.
While on antibiotics, it is suggested that anyone with whooping cough remove themselves from all social settings.
During that time, while a person is being treated we do recommend that they be excluded from social settings," Anderson said. "They are infectious during that time period."
Anderson said anyone who lives in the same household as someone with whooping cough should be cautious since they could have contracted the illness as well.
Whooping cough at the schools
Anderson said cases of whooping cough aren't typically treated in a school setting since parents are the ones who usually spot the symptoms first.
"The parents are the ones that will recognize the symptoms since they're occurring more frequently at night," he said. "Parents then notify the school nurse."
District 833 Communication Director Barb Brown declined to comment on how the school handles cases of whooping cough aside from saying they follow the procedures set by Washington County.
When a case of whooping cough is reported and confirmed at an elementary school, Anderson said the district and the county will typically send out a letter to all parents in the infected student's class.
At the middle school and high school level, it becomes more difficult since a student frequently changes classrooms and classmates.
"It's hard to know what population to notify," Anderson said.
An increase in cases
Over the past year, Anderson said Washington County has been seeing an increase in the number of whooping cough cases reported.
"We were starting to see an increase in pertussis cases at the end of the last school year," he said. "Cases continued to increase throughout the summer months. Now we're thankfully on a downward trend across all the school districts and the county."
Anderson said it's unknown what has caused the increase in whooping cough cases, but he suspects it has to do with an early waning of immunity to pertussis following vaccination.
The vaccination, DTaP, schedule for pertussis starts when a child is two months old with the first shot. Children receive additional vaccinations at four months, six months, 15-18 months, 4-6 years and 7-10 years.
Children later receive a TdaP booster vaccination at age 12.
However, Anderson said the increase of cases in children could stem from the vaccinations wearing off early.
Additionally, the cause could be that adults never received vaccinations.
"Adults are the reservoir for this organism," Anderson said. "They are the ones that are transmitting the organism to the susceptible kids."
For adults ages 19 and over, the vaccination consists of one DTaP vaccination followed by a TdaP vaccination every 10 years.
Anderson said Washington County Public Health & Environment Department is currently working with the Minnesota Department of Health and the Center for Disease Control to identify why the cases of whooping cough are increasing and whether or not a revision needs to be made to the vaccination schedule.
"What's causing this is still the million dollar question out there," he said.
Anderson said it's difficult to predict if this year's high number of cases was simply a fluke, or if something else is going on.
However, Anderson said it is very important for parents to recognize the symptoms of whooping cough, and get the illness diagnosed as early as possible.
"There are a whole lot of different infectious agents and causes of coughing, so to exclude someone from school because they have a cough is not an appropriate measure," he said. "But if a child has been diagnosed with pertussis, they need to be excluded from social settings for five days."