Pertussis Ain’t Just for Infants
Educating parents of adolescents about whopping cough.
by Sue Will, RN, MPH, NCSN, FNASN

PARENTGUIDE News March 2006

Pertussis, commonly known as whooping cough, is a highly contagious bacterial infection of the respiratory system that causes severe coughing spasms. 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 ages 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.

Almost 90 percent of school nurses are concerned about the recent surge in outbreaks of pertussis among adolescents, according to a new survey supported by the National Association of School Nurses (NASN). Many of these pertussis outbreaks are occurring across the country and originating in middle and high schools.

Since school nurses are the gatekeepers of adolescent health, NASN launched Pertussis Tools for Schools, a campaign designed to educate teachers, parents and teens about the signs and symptoms of pertussis. Parents and teachers are encouraged to log on to www.nasn.org to learn more about this serious disease and how to best protect against it.

The survey revealed that 75 percent of school nurses surveyed are extremely concerned about their students’ susceptibility to infectious diseases. Pertussis is of particular concern, as childhood immunization against pertussis wears off five to ten years after the last routine vaccination, which is typically administered when children are between 4 and 6 years old. Because of this waning immunity, many adolescents are unprotected against this serious disease.

Once made aware of the waning immunity against pertussis, an overwhelming 100 percent of school nurses polled agreed that a pertussis booster is crucial for preparing middle and high school students for a healthy school year. The good news is that a pertussis booster vaccine was recently approved by the U.S. Food and Drug Administration.

Additional Survey Findings
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 and peers.

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,” school nurses clearly play a pivotal role as health providers and educators.

About Pertussis
Pertussis can be difficult to detect because the first symptoms are similar to the common cold, with a mild fever, runny nose and 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 ten 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.

Historically, a pertussis vaccination was given in combination with diphtheria and tetanus (DTaP) in five doses given at 2, 4 and 6 months of age, 15 to 18 months of age and 4 to 6 years of age. Earlier this summer, the Advisory Committee on Immunization Practices recommended universal Tdap (Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed Tdap) booster vaccination for adolescents.

About NASN
The National Association of School Nurses’ core purpose is to advance the delivery of professional school health services to promote optimal health and learning in students. NASN supports school nurses in the many activities they perform daily to support students and their health. Health and education go hand in hand. School nurses promote health and safety for children and youth by:

— identifying health needs.
— managing school care for students with chronic disease (such as asthma and diabetes).
— implementing communicable disease control activities.
— providing first aid and emergency care.
— conducting health screenings, such as vision, hearing and height/weight screenings.
— serving as a liaison between the home, school and community.
— developing and implementing health programs and health education to promote normal growth and development and healthy lifestyle choices.
— developing school and district health policies including disaster preparedness.
Parents are encouraged to contact their child’s school nurse for additional information about pertussis and other health-related concerns.

Sue Will, RN, MPH, NCSN, FNASN, is president of the National Association of School Nurses. For more information about how to protect your tweens and teens from pertussis, log on to www.nasn.org and click on the Pertussis Tools for Schools link.