Whooping cough cases confirmed in Park Rapids

Confirmed cases of pertussis, also known as whooping cough, have been identified in students in several grades throughout Century Elementary and Middle School in Park Rapids, according to notification given to parents Dec. 7.

On Monday, parents at Hip Hop I at Northern Lights Academy in Park Rapids received notification that a confirmed/suspected case of pertussis had been identified in a student/staff person.

According to the Minnesota Department of Health (MDH), pertussis is a highly contagious respiratory tract infection that often begins with symptoms similar to the early stages of the common cold, such as a runny nose and a mild cough. A low-grade fever is also possible.

A persistent cough that occurs in bursts and may end with a high-pitch whooping sound develops after a week or two. Coughing attacks are more common at night and may continue for up to six weeks. Pertussis can lead to pneumonia, especially in infants.

According to the MDH, there have been 411 confirmed, probable and suspected cases of pertussis reported in Minnesota, as of Dec. 7. Pertussis is spread through the air in droplets produced when coughing or sneezing.

The first known case of pertussis confirmed in the area was a sixth grader at Century Middle School in late November.

Park Rapids School District nurse Jennifer Jackson said the rumor that there are 40 kids with pertussis at Century is a "huge overestimate."

"I have to wait for calls from the state to give me those confirmed numbers," she said. "It's been less than 10. It's standard procedure that the state says if there is a case we want to make everyone aware so nothing continues to spread. We want to watch out for everybody."

No suspected cases of pertussis have been reported at the high school.

Jackson said the school follows the state guidelines that recommend a booster for Tdap (tetanus, diptheria and pertussis) in 7th through 12th grade.

"Immunity does wane in some cases," Jackson said. "That can be a reason why students get pertussis. We talk with parents and make sure they are following through with the recommended immunization schedule. If parents choose not to immunize we have to have a conscientious objector form."

She said parents should consult with their pediatrician to see if children should be immunized earlier than seventh grade because of the presence of pertussis in the community.

Parents with concerns about their child's exposure to pertussis may contact Jackson at 237-6441.

MDH guidelines

The letter sent to parents of Century students and Northern Lights Dance Academy students states, "although you/your child may have received the pertussis vaccine, immunization is not always 100 percent effective and immunity decreases over time."

MDH recommends students who received the letter be evaluated by a healthcare provider if they have a cough lasting longer than seven days. The nasal passage is swabbed and examined in a lab to detect if there are pertussis bacteria present.

The letters goes on to state, "Patients who are being tested and treated for a cough of less than 21 days should refrain from routine activities until there is a negative test result or the individual has completed at least five days of an appropriate antibiotic."

MDH says persons with pertussis can spread the disease to others during the first three weeks of coughing, if not treated with antibiotics. Once treated with antibiotics for five days, the person can no longer spread the disease.

The best prevention is for children to be fully vaccinated, for women to be vaccinated during each pregnancy and for adolescents and adults to get a booster shot. According to the MDH, treatment for pertussis is most effective during its early stages. Making sure vaccinations are up to date is the best way to prevent pertussis. The DTaP vaccine is given to infants and children under age 7. The recommended schedule is five doses of vaccine given at 2 months, 4 months, 6 months, 12-18 months and 4-6 years.

The MDH recommends a Tdap vaccination for anyone 10 years or older. Adolescents and adults who have not yet received this vaccine are encouraged to get vaccinated.

Anyone with questions or concerns should contact their health care provider or call MDS at 877-676-5414. The MDH website also has a wealth of information about pertussis for parents in five languages, including Spanish.

Prevention tips

MDH recommends following the guidelines for infectious disease control of washing hands often, staying home when ill, and covering a cough with a tissue or coughing into your sleeve.

Wendy Gullicksrud, the infection prevention coordinator at CHI St. Joseph's Health, said she has not seen any positive pertussis from tests at the emergency room or hospital.

"I know there's a lot of respiratory stuff going around," she said.

Gullicksrud said when her grandchildren were born her doctor told her to have a pertussis booster. "That is because infants have not had the full series of shots and are more susceptible to the illness," she said.

Tetanus shots given to adults are either TD (tetanus/diphtheria) or Tdap, which includes pertussis. Adults should check with their provider to make sure they are protected. "They should be vaccinated if they are around kids who can get way more sick from it," she said. "In some cases, pertussis has led to pneumonia in infants. It can also affect people with breathing issues like asthma."

Gullicksrud said pertussis used to be called "the 100-day cough."

"When someone tells me they have a cough, they can't get rid of I always wonder if it might be pertussis," she said. "I had one gal come up a few years ago and say she had this cough and wanted to be tested for TB. I suggested she get tested for pertussis first and she tested positive."

Since symptoms don't develop until a week or more after exposure, pertussis can spread before it is diagnosed. "Parents will often send kids to school if they don't have a fever even if they have a cough," she said. "In the seven days before they get tested, they've probably exposed a lot of people."

Gullicksrud said "respiratory hygiene" is key to stopping the spread of the disease. "They are teaching kids now to cough into their arm instead of their hand so they're not touching a door handle and spreading disease," she said. "Students should wash their hands frequently. Pertussis is not airborne. It's spread by droplets. If they're covering their cough and washing their hands they shouldn't be passing that on."

According to the National Institute of Health, nasal mists can provide some protection by keeping the noise moisturized, as can applying Neosporin or Vaseline inside the nostrils with a Q-tip.

"Pertussis had been pretty much taken care of, but now we're finding there are more cases," Gullicksrud said. For many adults, she said the disease may run its course while appearing to be just a cold that hangs on. "It's the kids that may have more trouble with it," she said.

She said people should stay six feet or more away from anyone who is coughing. Older children who are coughing should avoid close contact with younger children. In daycare, the droplets can get on toys and another child puts in their mouth so toys should be sanitized frequently.

The Centers for Disease Control and Prevention data shows the vaccine series for children is 80 to 90 percent effective. "By age 2, they are pretty well protected, but it wanes as they age," Gullicksrud said.

The CDC website shows pertussis cases have been on the increase since the 1980s. The site explains that the acellular pertussis vaccines used now may not protect as long as the whole-cell vaccine doctors used through the 1990s. The U.S. switched from using whole-cell vaccines because they were associated with side effects such as fever, pain, swelling at the injection site and in rare cases adverse neurological reactions.