Whooping cough reported in county schools

Pertussis, commonly referred to as whooping cough, is making an appearance in local elementary schools.
According to Orange County Public Schools Director of Student Services Eugene Kotulka, 17 students had the illness as of last week and 11 students had the disease earlier in the month. He said all of the cases are at Lightfoot and Unionville elementary schools.
"It takes about two weeks for the virus to incubate so it comes in waves," he said. "This could happen for a while."
According to the Center for Disease Control (CDC), Pertussis is a contagious disease caused by bacteria which is found in the nose and throat of an infected person. It spreads through the air in droplets produced by sneezing or coughing.
Pertussis begins as a cold with a runny nose, sneezing, mild fever and coughing. The cough usually lasts one to two weeks before worsening. The second stage of the illness includes uncontrollable coughing followed by a whooping noise when the person breathes in air. During these coughing spells a person may vomit or have their lips or face appear bluish in color from a lack of oxygen. This stage may last four to six weeks.
Anyone can contract pertussis but the illness most commonly occurs in small children who have not yet been vaccinated, according to the Virginia Health Department.
Among vaccine-preventable diseases, pertussis is one of the most commonly occurring ones in the United States, according to the CDC. The DTaP vaccine, which protects against diphtheria, tetanus and pertussis, is recommended for children at 2, 4 and 6 months old and then again between 15 and 18 months and old and between ages 4-6.
However, according to the CDC, the vaccine is not 100 percent effective and fades over time. A booster shot should be given to children between ages 11 and 12 or to adults who haven't received a booster in their adolescent years.
Dr. Dana Bradshaw, district health director for the Virginia Department of Health's Rappahannock-Rapidan Health District, said children and adults who are vaccinated, yet still contract the disease, should experience a milder case.
"We do expect persons who are immunized to be at least partially, if not fully, protected against pertussis and have milder illness," he said.
He said according to the CDC, pertussis infections in those people who are partially protected by the vaccine may be asymptomatic or present as illness ranging from a mild cough to a persistent cough. Still, those infected may transmit the disease to others who have not been vaccinated. Often, adults are found to have the first case of the disease in a household and often spread the disease to children.
"Unimmunized infants are most vulnerable to pertussis," Bradshaw said. "All pertussis deaths in the last several months in the California experience have been in infants under three months of age. It is especially important to make sure everyone with new babies in the family or who are around these infants are fully vaccinated to avoid exposure to persons with cough illness or symptoms suggestive of whooping cough (pertussis)."
And, though Orange County Schools are reporting 17 cases, there could be more. Bradshaw said the cases reported to the CDC from the health department use the criteria of "confirmed" and "probable" cases, though the department follows up on suspect cases. Doctors may choose to diagnose and treat patients on their own impression, with or without laboratory confirmation. He said the lab test for pertussis is a culture to verify bacteria is present. However, he said, the bacteria can be hard to grow in culture.
"It is likely that year to year, many pertussis cases go unrecognized, particularly cough illnesses that have lasted more than two weeks," he said.
For now, Kotulka said the school system is following health department guidelines and is working closely with parents who are encouraged to notify the school if a child has come down with the illness.
"The teamwork between the parents and staff has been outstanding," Orange County School Superintendent Dr. Bob Grimesey said.
Typically, children with pertussis are treated with a five-day antibiotic and are admitted back to school once the treatment has concluded. For more information, visit www.ocss-va.org.