Survey Reveals Recent Rise in Pertussis Cases in Teens

CASTLE ROCK, Colo. -- A new survey supported by the National Association of School Nurses (NASN) reveals that almost 90 percent of polled school nurses are concerned about the recent surge in pertussis outbreaks among adolescents. In response, NASN has launched "Pertussis Tools for Schools," a campaign designed to educate school nurses, teachers, parents and teens about the signs and symptoms of pertussis. Parents and school nurses are encouraged to log on to www.nasn.org to learn more about this serious disease and how best to protect against it.

Commonly known as whooping cough, pertussis is a highly contagious bacterial infection of the respiratory system that causes spasms of severe coughing. Reported cases of pertussis have risen nearly 20-fold since 1976. According to the Centers for Disease Control and Prevention (CDC), there were almost 20,000 cases in 2004 -- the highest number of reported cases in more than 40 years. Adolescents aged 10-19 are being hit particularly hard, with almost 40 percent of cases reported to the CDC in 2004 occurring in this age group. Alarmingly, there was a 743 percent increase in reported adolescent pertussis cases in the last decade.

"Given the number of pertussis outbreaks across the country last school year, I am not surprised that many nurses surveyed cited whooping cough to be a significant student health concern," said Sue Will, RN, president of NASN. "I hope that the Pertussis Tools for Schools campaign will help everyone associated with our schools to learn more about this serious condition so that we might be able to better manage and even avoid outbreaks this school year."

The survey revealed that 75 percent of school nurses surveyed are extremely or very concerned about their students' susceptibility to infectious diseases. Pertussis is of particular concern, as childhood immunization against pertussis wears off five to 10 years after the last routine vaccination shot, typically administered when children are between four and six years old. Because of this waning, many adolescents are vulnerable and unprotected against this serious disease.

Although only one in five school nurses surveyed saw cases of whooping cough diagnosed in their schools last year, 64 percent reported that they believe symptoms typically associated with the disease (namely severe or persistent coughing) are cause for extreme concern. Teens, in whom classic signs and symptoms of pertussis are often absent, may go undiagnosed and be the source of infection for susceptible family members.

"School nurses are at the forefront of adolescent health," Will continued. "With 93 percent of school nurses citing that they are typically the 'first healthcare professional to notice potential infectious disease related symptoms in their students,' we clearly play a pivotal role as health providers and educators."

Pertussis can be difficult to detect because the first symptoms are similar to the common cold, with a mild fever, runny nose and a cough. Symptoms generally progress to more severe coughing episodes, often with a high-pitched "whoop," followed by vomiting. These severe coughing spells can last up to 10 weeks. Afflicted teens are often forced to sit on the sidelines, unable to attend classes or participate in sports and social events for a week on average because of the severity of their illness. A person experiencing these severe coughing spells may become blue in the face, and infants may actually stop breathing for a few seconds. Between coughing spells, it is typical for individuals to appear symptom-free. While pertussis is threatening to all, this highly contagious disease can be serious in infants who are too young to be fully immunized.

Historically, pertussis vaccination was given in combination with diphtheria and tetanus (DTaP) in five doses given at two, four and six months of age, 15 to 18 months of age and four to six years of age. However, immunity to pertussis wears off five to 10 years after the last childhood dose, leaving many teens unprotected against the disease.

Earlier this summer, the Advisory Committee on Immunization Practices (ACIP) recommended universal Tdap [Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed (Tdap)] booster vaccination for adolescents. Once made aware of the waning immunity against pertussis, an overwhelming 100 percent of school nurses polled agree that a whooping cough/pertussis booster is important for preparing middle and high school students for a healthy school year. The good news is that such a pertussis booster vaccine was recently approved by the U.S. Food and Drug Administration (FDA).

Source: National Association of School Nurses