The Free Press, Mankato, MN

September 23, 2013

School's pertussis case no reason for alarm

Whooping cough cases not an outbreak

By Robb Murray

---- — NORTH MANKATO — It's not often a letter comes home warning parents that a student in their child's school has an infectious illness that could be very dangerous if contracted by the wrong person.

That's what happened last week for parents of kids at Dakota Meadows Middle School. In this case, it's pertussis, also known as whooping cough.

"A suspect case of pertussis (whooping cough) has been identified in your child's 8th grade class," the letter from the school nurse said. "Due to increased activity of pertussis in the community, the Minnesota Department of Health is recommending that we encourage children to be evaluated by a health care provider if they have a cough lasting longer than seven days."

Sounds bleak, right? After all, pertussis can be deadly for infants.

According to the national Centers For Disease Control and Prevention, "About half of babies younger than 1 year of age who get the disease need treatment in the hospital. About 1 in 4 hospitalized babies with whooping cough get pneumonia (lung infection), and about 2 in 3 babies will have trouble breathing. Whooping cough can be deadly for 1 or 2 in 100 babies who are hospitalized."

But Brad Krier, a Mankato-based epidemiologist with the Minnesota Department of Health, said it's way too early to get concerned about a community-wide outbreak.

Dakota Meadows is among a handful of schools so far this school year where parents of those students got letters in the mail about a pertussis case. Three other cases have been identified so far this year at other schools, resulting in three other letters.

The vaccine for pertussis is between 80 and 85 percent effective. Infants, the most vulnerable group, get shots at 2, 4 and 6 months old, again at 15-18 months, and again at 4-6 years. A booster is available at age 11.

Last year was an epic one for pertussis. In 2012 there were more than 4,000 cases in Minnesota.

"That was the highest we've seen since 1938," Krier said. "This year, we're on pace to hit about 1,000."

At the schools, they come at pertussis and other infectious illnesses with a proactive approach.

Stephanie White, director of special education for Mankato Area Public Schools, said the school district's policy is to not allow any student to come to school who isn't current on immunizations. To get out in front of that, they send notices home with students and inform parents at conferences with the facts about immunizations and the school district's policy.

In rare cases, students may enter sans immunizations if they are granted a waiver based on religious reasons. But White said those kinds of cases are extremely rare.

For the most part, though, almost all students are current on immunizations.

"Our medical facilities do a really good job of helping families keep up on those things," said White, who supervises the school nurses.

Krier says parents in schools such as Dakota Meadows should pay attention closely to their child's cough. If it lasts longer than seven days, he says, it may be time to consult a physician. Antibiotics can be prescribed to treat the disease.

"We haven't seen a lot in the area, just a handful," Krier said. "But when we see pockets, we try to really coordinate with local public health and area providers so everyone knows what the recommendations are."

Left untreated, pertussis goes away by itself. But it can take a while; perhaps up to a month or two.

"It used to be called the 100-day cough," Krier said.