Kentucky county declares pertussis outbreak
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Key takeaways:
- Pertussis — also known as whooping cough — began spreading through schools in Kentucky’s Fayette County in late April.
- County health officials recommended preventive antibiotics for high-risk students.
A county in Kentucky has declared a pertussis outbreak following the confirmation of nine cases since late April, including three this past Monday.
“All central Kentucky caregivers should be on the lookout for signs and symptoms of pertussis while ensuring their kids are up to date on their vaccines or fully vaccinated with the booster,” the Lexington-Fayette County Health Department said in a statement.
Pertussis, which is caused by the bacteria Bordatella pertussis, is a contagious respiratory illness that spreads easily through the air and starts like a common cold, although coughing can persist for weeks or months, according to the CDC. People can be contagious for at least 2 weeks.
Antibiotics taken early in the infection can shorten the length of time a person is contagious, but people with mild symptoms who are unaware they have it can still spread it. Pertussis can be prevented with vaccination — children aged younger than 7 years receive DTaP, and older children and adults receive Tdap.
The Kentucky outbreak started with two confirmed cases — one each at Bryan Station High School and Lexington Catholic High School in late April, according to the health department. A third case was confirmed the first week of May, also at Bryan High School, and a fourth was confirmed at the high school on May 14.
On May 15, the health department suggested that parents, caregivers and clinicians be on alert for potential pertussis cases because it was “spreading through Lexington schools.” The outbreak declaration on May 20 noted that nine cases had now been confirmed.
The three new cases were at Lafayette High School, Sts. Peter and Paul Catholic School and a community case in a person in their 80s.
The health department recommended preventive antibiotics for high-risk students who were exposed to pertussis, including those with a chronic illness or weakened immune system.
“Any school-age children with symptoms of pertussis should stay home from school and visit their health care provider for evaluation, even if they have previously been vaccinated,” the health department said. “If found to have probably or confirmed pertussis, they should remain out of school until completion of their antibiotics.”
References:
- CDC. Whooping cough (pertussis): About whooping cough. https://www.cdc.gov/pertussis/about/index.html. Updated April 2, 2024. Accessed May 22, 2024.
- Central Kentucky parents/caregivers should be on alert for pertussis. https://www.lfchd.org/19478-wmcecs/. Accessed May 22, 2024.
- LFCHD declares pertussis outbreak in Lexington. https://www.lfchd.org/19595-ytllkk/. Updated May 20, 2024. Accessed May 22, 2024.
Perspective
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In the current Kentucky pertussis outbreak, nine cases of pertussis have been identified in individuals across ages. There are at least three lessons not learned.
First, pertussis sometimes feels like it is gone, but it most certainly is not. Health care providers should have a reasonable index of suspicion for respiratory infections that do not follow the typical course of infection. Although antibiotics may not adequately eradicate symptoms, transmission is substantially lowered with azithromycin.
Second, vaccination is key. We should encourage vaccination during each pregnancy, starting at 2 months of age for infants, during adolescence and every 10 years as adults, as an alternative to Td.
Third, even with relatively high vaccine rates for pertussis — more than 80% in many areas — we have learned from elegant work in baboons that the currently available vaccines prevent disease very well but likely do not prevent colonization and transmission. Therefore, we continue to look for ways to improve pertussis vaccines, maximizing both safety and effectiveness.
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