May 28, 2004

Gail McCurdy RN BSN
Epidemiology Specialist
Troop B

Update on Pertussis outbreak in Cole, Callaway and Boone Counties

To update you on the information that I heard in a meeting yesterday regarding the Pertussis outbreak in Cole, Callaway and Boone Counties:

Kena McAfee from Boone County Health Department reported yesterday that there were 13 confirmed cases of Pertussis in Boone County. Most of these were associated with a soccer situation. And most of these were aged 12-15. She also said that they had 2 cases totally unrelated to the soccer situation that they had no real tie to anything in Jefferson City with their Pertussis.

Melodie White, Infection Control Nurse said that there was only one new case of Pertussis diagnosed in the last week in Jefferson City, MO. They believe that they have the outbreak in control.

The current recommendations for testing and suspicion are:
Tests for pertussis should be performed on anyone that strongly demonstrates pertussis like syndrome, also anyone with an exposure and any type of cough.

Do not test (unless other extenuating circumstances): asymptomatic contacts of Pertussis cases and those persons with upper respiratory symptoms only.

Dr. Cooperstock, Pediatric Infectious Disease in Columbia, MO, spoke yesterday on his cases and the syndrome in specifics. He told us that there is no seasonality occurrence with Pertussis. It takes place anytime, anywhere. Once you have had Pertussis, the disease, that it is possible to acquire ParaPertussis and, a study in Germany strongly supports that, it may be possible to acquire Pertussis again, once immunity wanes. Therefore he recommends that testing take place as above and prophylaxis with contacts occur unless the disease is so widespread that it is futile to prophlax
all the contacts.

Lastly, he states that there is a strong association of lymphocytosis with this disease that is not always consistent with all other types of respiratory illness that may mimic it. In prophylaxis, he recommends that Erythromycin be avoided for anyone under 6 weeks of age, due to the potential for pyloric stenosis that it can cause. There are actual documented cases of infants developing pyloric stenosis with the use of Erythromycin.

This is information from a talk that Dr. Cooperstock did at University of Missouri on May 27, 2004.

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