In June Children’s Hospital Central California hosted a team from the Centers for Disease Control and Prevention (CDC). The CDC team used the recent increase in pertussis in Central California to evaluate and improve diagnostic tests for pertussis.
The four-person CDC team was at Children’s Hospital for about three weeks, and wrapping up their activities by the second week in June. Their work focused on the families of patients that Children’s identified as having pertussis. Children’s Hospital staff initially indentified the patients, then the CDC staff talked to the family to find out if any other family members had a prolonged cough, a key symptom of pertussis. After talking to them about the illness and their immunization history, the CDC representative took blood and nasal wash samples from those family members and forwarded them to the CDC lab in Atlanta for evaluation.
“We are really looking to see how well the tests work and which ones work best for each age group,” said Dr. Michael Jackson, CDC epidemiologist. ”We’re not diagnosing individuals, but using the information to understand how well present tests work, and to help improve testing in the future.”
Children’s Hospital, along with the rest of California, has seen a dramatic increase in pertussis cases since the first of this year. Pertussis, also known as whooping cough, is a vaccine-preventable disease that can be fatal. It is a serious infection of the respiratory tract caused by Bordetella pertussis bacteria, and is most severe in infants under one year. The early symptoms are similar to a common cold, and include a runny nose, sneezing, mild fever, and dry cough. These are followed by severe coughing spells that last for over a minute. Between coughing spells the child may gasp for air with a characteristic “whooping” sound, hence the term “whooping cough.” Pertussis causes about 10-15 deaths a year in the United States, generally in infants. It also occurs in teenagers and adults, but the illness is less severe and more likely to be misdiagnosed.
Pertussis is highly contagious, and is spread through the air when an infected person coughs or sneezes. The incubation period is normally 7 to 10 days, but can range from 5 to 21 days. Pertussis is treated with antibiotics and may require hospitalization.
The CDC staff included Dr. Jackson, a surveillance coordinator, a medical student and a microbiologist. They contacted the patient families with assistance from Children’s Hospital staff, collected the samples, and then prepared them for transport to the CDC. The study was performed in conjunction with the California State Department of Health.
Important points about pertussis:
- Pertussis in adolescents and adults is often misdiagnosed by physicians.
- It is most often incorrectly diagnosed as bronchitis or asthma.
- Infants most often catch pertussis from an older family member.
- The initial symptoms of pertussis in small babies are often deceivingly mild. They include a runny nose and mild cough. There usually is no fever. The illness may be mild for a few days and then suddenly get worse and cause severe respiratory distress.
- Pertussis is preventable with up-to-date age appropriate immunizations.