The number of emergency room visits attributed to COVID-19, RSV, influenza, and other respiratory viruses in Massachusetts is starting to come down from a post-holiday peak, but is there a new concern on the horizon?
On Jan. 12, Bedford High School families received notice of a single case of whooping cough in the BHS community.
While sides may be divided on the return of many retro fashion trends such as body suits, bomber jackets, velvet, and mom jeans, the rise in Victorian-era illnesses must certainly be unanimously unwelcome. There is a wave of leprosy in Florida, a global measles outbreak, and an increase in syphilis cases, not to mention that bubonic plague, tuberculosis, and polio still exist.
Should people be worried? Most of these illnesses are treatable and controllable with preventative vaccinations but still can be dangerous when spread to certain populations, and that’s the situation with whooping cough, also known as pertussis.
According to Heidi Porter, Bedford’s Director of Health and Human Services, the single known case of pertussis recently announced is the only known case in town this past year. In the last five years, there were five additional cases of pertussis in Bedford – two cases in 2018 and three cases in 2017. Each identified infected individual was between the ages of 14 and 17.
Going back 18 years, there have only been 57 total cases of whooping cough identified in Bedford, the majority of which also fell in the population of high school age patients.
According to information from mass.gov, pertussis is a disease caused by bacteria that causes an infection in the lungs and airways. Like other respiratory illnesses, it’s contracted through breathing in the bacteria when someone with the infection sneezes, coughs, talks, or otherwise sprays germs that are then inhaled.
Once contracted, pertussis can start like a cold that develops into a cough. The cough becomes progressively worse and may result in severe coughing spells over time. The illness can stretch out for many weeks and therefore has been nicknamed “the 100-day cough.”
Porter says, “Pertussis is highly contagious, but not as much as COVID-19. It is contagious for a week prior to the cough onset, and three weeks after.”
Pertussis is diagnosed by a laboratory test through a physician’s office, but can often go undiagnosed when mistaken for other respiratory illnesses. Once a diagnosis is confirmed or suspected, the treatment of the infection is typically antibiotics, rest, and fluids. Antibiotics may also shorten the time that an infected person is contagious, or prevent someone who has been exposed from getting ill.
“If antibiotics are started, then the contagious period ends after five days of those antibiotics being taken,” Porter said.
The illness is usually mild in older children and adults, but can be particularly dangerous for infants.
Mass.gov says, “Vaccination is the best way to protect against pertussis.” Infants and children under the age of 7 are recommended to be inoculated through the DTaP vaccination series (a vaccine that includes diphtheria, tetanus, and pertussis). Tdap is the booster dose formulation of the same vaccine that is recommended for adults and children over the age of 11.
The reason whooping cough is often seen in high school students, according to Porter, is contraction by unvaccinated or under-vaccinated individuals who may not have completed their DTaP sequence, waning immunity from those who have not yet received the Tdap booster (typically starting around age 11 or 12), and asymptomatic carriers spreading the germs.
At BHS and in town, school nurses and the Health Department are monitoring the population and are on the lookout for others with symptoms that may go undiagnosed, as well as sharing information on the disease, and encouraging residents and those who work in town to keep vaccinations up to date.
Porter recommends that anyone with respiratory symptoms (regardless of the cause) should stay home if they are sick and wear a mask around others to avoid spreading germs.
Vaccinations and preventative measures should be able to maintain control of whooping cough and other Victorian-era illnesses just like a corset maintained the shape of Victorian women.
Any questions about pertussis can be directed to the Massachusetts Department of Public Health at (617) 983-6800, or the Bedford Health Department.