The Pennsylvania Department of Health is monitoring an outbreak of pertussis in Monroe County after multiple students, primarily in Stroudsburg Area School District, became infected with the respiratory illness also known as whooping cough.
The district announced just before students left for holiday break that it was informed by the Department of Health that it had identified cases among several district students. Lehigh Valley Health Network and St. Luke’s University Health Network have each assisted with the care of patients with pertussis as well as those exposed in Monroe County.
Dr. Jennifer Janco, chair of pediatrics for St. Luke’s University Health Network, said while the network can’t give a specific number of patients they have seen, it has been increasing day by day and those affected are primarily middle school- and high school-aged children.
She added that it appears to be spreading to other nearby areas, such as Carbon County. York and Cumberland counties also are seeing their own outbreaks, she said. However, she said she was not aware of cases in Lehigh or Northampton counties.
Pertussis is a highly infectious respiratory illness that gained the nickname whooping cough because of the telltale whoop that many sufferers exhibit, a kind of deep wheezing sound that occurs after the cough. For some, especially those who have been immunized to pertussis, the symptoms may be more similar to a common cold or any number of other respiratory infections, but others will experience fits of coughing with that whoop at the end.
“You have these forceful fits of coughing and you cough so hard that you follow with this big inspiratory sound,” Janco said. “In older children, it can be that very forceful cough. Sometimes the cough is so forceful that you cough so hard you vomit, you cough so hard you have broken blood vessels in your eyes. Some people have actually broken a rib.”
While anyone can be infected with pertussis, babies are the most vulnerable. Before a vaccine was introduced, pertussis was a top killer of young children.
“Infants are too little, they don’t have the energy to whoop, so they will just cough, cough, cough and then make a cough so hard that they literally lose air and turn blue,” Janco said. “You will see this blue-gray color and they will actually stop breathing. That can be a telltale sign when you have an infant who’s turning blue.”
Pertussis can last for months. The first one to two weeks are usually similar to a cold, followed by two to six weeks of the signature coughing fits, followed by up to two months of residual coughing. Complications can include pneumonia secondary to the pertussis infection, and seizures.
Janco said those who want to protect themselves and those close to them from the disease should make sure their families are vaccinated. Babies two months and older can get their first shot of the tetanus, pertussis and diphtheria vaccine; she added that pregnant mothers should also get the shot to protect their newborn babies.
Janco said that those who believe they or a family member have pertussis or know they were exposed should take specific steps to ensure they are receiving diagnosis and treatment in the best possible setting for everyone involved.
She said unless the case is severe, such as a blue-faced infant or small child, people should not visit the emergency room for a suspected case of pertussis. She added that handling diagnosis through a primary care doctor for non-severe cases will be much less likely to result in spreading the disease to others than by visiting an urgent care where the disease could be potentially spread to an entire waiting area of people.
She added that those who have pertussis or are awaiting pertussis test results should also isolate at home. St. Luke’s will provide notes for work or school as needed.
Treatment involves the use of an antibiotic that will dramatically reduce the period that the disease is transmissible, along with isolation. She said if a patient is receiving antibiotic treatment, isolation only needs to last five days. Those who choose to forgo antibiotic treatment or cannot receive it should remain in isolation for 21 days.
“It doesn’t necessarily cure you or shorten your course but it does try to contain the spread,” Janco said.
