A Perilous Pertussis Peak

Microscopic Image of Bordetella Pertussis bacteria

Pertussis is a highly contagious disease caused by the bacteria named “Bordetella Pertussis,” and is associated with a high mortality rate. Its activity seems to be cyclical, with a peak about every three to five years. The last peak was 5 years ago in 2005, where 8 infants died from this disease in the State of California alone. Ominously, Pertussis is expected to peak again this year, and so far has caused 4 infant deaths in California since January 2010. Twice as many cases are being reported this year compared to the prior year thus far, and the year is only half over.

Fortunately, it is a vaccine preventable disease. However, those kids who have not completed their vaccination series and those kids too young to be fully vaccinated whom are less than 3 months of age are at greatest risk. It often begins with a rather mild onset of a runny nose without a fever, and its diagnosis is often delayed because of its mild appearing beginning stages. There may also be a mild cough initially, but it rapidly progresses to pneumonia, respiratory distress, cessation of breathing, or even seizures.

In young infants, a blood test reveals an elevated white blood cell count greater than 20,000 cells with a greater than 50% shift towards lymphocytes (a specific type of white blood cells). In addition, a nasopharyngeal swab (a swab placed in the back of the nose) is the diagnostic test of choice.

The department of public health is asking to keep a closer eye on young infants, especially those less than age 3 months presenting initially with mild symptoms, and to treat suspected cases promptly with Azithromycin. Treatment should not be delayed in suspected cases pending test results. Infants should be monitored very closely and considered for hospitalization in a facility with an Intensive Care Unit (ICU).

Pertussis is prevented with the vaccine, and all infants and healthcare workers should be immunized.

Please report all suspected and confirmed cases to your local public health department.