Whooping Cough Scare In Middle School

Most kids vaccinated, but many adults are not

    Pertussis, the highly infectious bacterial disease also known as whooping cough, has made an appearance at the East Hampton Middle School, where one case was reported last week. A letter from the Suffolk County Department of Health was almost immediately put up on the East Hampton Union Free School District’s Web site, and was given to staff and parents at all the schools in the East Hampton system.
    Dr. Gail Schonfeld of East End Pediatrics said on Tuesday that she has diagnosed four cases in the last three weeks, including a 3-month-old infant who was admitted to the hospital but eventually recovered.
    Most children have been vaccinated against the illness, and the vaccine is reported to be 95 percent effective. However, when a child, particularly a baby, gets infected with pertussis, the results can be very serious and sometimes fatal.
    Pertussis is spread through the air by the cough of an infected individual. A course of antibiotics is usually helpful, while cough syrups and elixirs are not.
    According to the Suffolk County Department of Health, in a letter that is posted on the East Hampton School District’s Web site, “A person with pertussis is infectious for 21 days from the start of the cough or until he/she has been on five full days of appropriate antibiotic therapy. Children and adults may be susceptible and still develop pertussis even if they are up to date with their vaccinations, as immunity to pertussis wanes over the years.”
    Whooping cough earned its name by the distinctive whooping sound made by someone with the illness as they attempt to draw in breath. “In between coughing fits, a patient could feel pretty good,” Dr. Schonfeld said. “But when they start coughing, they can’t stop. There is really thick mucus that blocks the airways, so there is a feeling of not being able to breathe.”
    Patients with pertussis often have other cold-like symptoms: fever, nausea, a runny nose. But it is the whooping and gasping for air that are the surest signs. In other countries, it is sometimes known as the “100-day cough.”
    According to the Web site for the World Health Organization, in 2008, 16 million people were affected worldwide and 195,000 children died from the illness.
    “Pertussis has been with us a long, long time,” Dr. Schonfeld said on Tuesday. “Only 10 percent of the cases were diagnosed until recently, but now we have a test that’s fairly accurate.” The test involves a “skinny little Q-tip” being inserted way back in the throat. “It’s not a really pleasant sensation,” she said.
    Up until 2005, she continued, there was no vaccine approved for children over 7 years old. Therefore, many adults could have the disease without knowing it. “If a cough lasts for more than a month in an adult, one-third of the time it’s pertussis,” Dr. Schonfeld said. Only a small percentage of adults in the U.S. have been vaccinated, but there is currently a campaign in progress to encourage adults — particularly those who spend time around a newborn — to get immunized.
    Another unpleasant fact: Getting pertussis once does not bring immunity to the illness. “You can get it more than once,” Dr. Schonfeld said.
    Fred Weinbaum, the chief medical officer at Southampton Hospital, acknowledged that pertussis in adults over 55 years old is fairly common, because of the decreased immunity as time passes. However, he added that the disease is not frequently spread, since most of the other people around an infected person are usually inoculated against it.
    Richard Burns, the interim superintendent of the East Hampton School District, spoke on Tuesday about the situation at the middle school. “The infected child was, of course, immediately removed from the premises, and is already fully recovered and back at school. The facilities, at least any facilities that the child had direct contact with, were cleaned and sterilized. I think we followed the best practices for this kind of situation, and managed to keep it under control,” he said.
    The superintendent’s office sent a letter to staff, parents, and guardians on Friday reiterating the points made by the Department of Health and also advising parents or guardians with any concerns at all to contact the nurse in their child’s school.
    “Suffolk County continues to see an increase in pertussis,” read the Suffolk County Department of Health’s letter. Last June, there were 40 cases of whooping cough reported in Suffolk County, and in the fall the disease made its way to the South Fork, with two confirmed cases in the Southampton School District.
    Dr. Schonfeld, however, remains unperturbed, and put forth the possibility that “this may not be an increase in cases — it’s just that we are better able to diagnose,” she said.
    “I do not see this as a catastrophe, like the plague has descended,” she said, adding she did not see this wave of whooping cough becoming epidemic in proportions. “But it’s right for us to publicize this and explain what to look for.”