Cases of whooping cough are affecting some Palo Alto middle and high school students, prompting school officials to send students with any type of cough home and to the doctor for testing, a school district spokesman said this week.
The highly contagious disease, also called pertussis, has been confirmed in students at three schools: Jordan Middle School and Palo Alto and Gunn high schools. Students who have already been vaccinated have been confirmed with whooping cough, underlining the importance of receiving booster shots since the shot does not provide lifetime immunity.
The school district has worked closely with public health officials since October, when the first cases were reported at two different schools, said Jorge Quintana, Palo Alto Unified's communications coordinator. Out of an abundance of caution, any student with a cough has been sent home with instructions to be tested by a physician. Students are not allowed back to school until they have tested negative for the disease or received appropriate antibiotics.
The local outbreak is marked by students who have already been vaccinated, according to the Santa Clara County Public Health Department. The vast majority of cases are part of outbreaks among vaccinated middle and high school students "because immunity from the vaccines wanes rapidly, leading to cyclical increases in pertussis cases every few years," county officials said in a Dec. 8 advisory. Booster doses are needed throughout life.
Whooping cough is marked by weeks of severe spasmodic coughing, vomiting and gasping for breath with a deep "whooping" inhalation. Pertussis has three stages, which include with what is called a catarrhal stage of flu-like symptoms, sneezing and occasional cough, (but rarely a fever) lasting one to two weeks, according to the California Department of Public Health. The coughing gradually becomes more severe and the patient enters a second, or paroxysmal, stage characterized by spasms of severe coughing and whooping.
Coughing, whooping and vomiting decrease over time, but they may return with subsequent respiratory infections. This third, or convalescent, stage typically lasts six to 10 weeks, according to the state public health department.
The disease is especially harmful to very young children, and deaths do occur in some cases. Infants less than a year old might have a shorter first stage, but they might gag, gasp or stop breathing, according to the public health department. Their face might also turn blue, purple or red. They might not have the the noticeable cough or whoop, officials said.
Because pertussis is spread by coughing, Quintana said any report of a possible case is taken seriously. The district follows county health department protocol and has communicated the health risks to parents, sending letters to parents at the three schools about the outbreak and a more general message to parents of students at all other schools, he said.
The school district and public health department are currently working to address "numerous" cases, but Quintana did not provide a specific number. Santa Clara County had 44 cases of suspected whooping cough between Oct. and Dec. 6. As of Dec. 14, 22 cases were confirmed, according to Santa Clara County Public Health Department officials. That number is not much higher than last year at this time, however, when 17 cases were confirmed, department spokeswoman Joy Alexiou said. But the number could rise once the probable and suspected cases are confirmed, she added.
The state health department recommends that infants start receiving the whooping cough vaccination series, or DTaP, as early as 6 weeks old. Even one dose of the vaccine may offer some protection against fatal whooping cough disease in infants, the department noted. Young children need five doses of vaccine by kindergarten. Students in seventh grade need to have a booster (Tdap), but adults should also receive a booster shot, especially if they are in contact with infants or are health care workers. Most adults have not yet received Tdap, the health department said.
Pregnant women should also receive the booster in their third trimester at the earliest opportunity. Officials recommend the booster during each pregnancy, even when a woman has received the shot beforehand. The booster will help babies during the most vulnerable period after birth until they are old enough to receive the vaccine, officials said.
The latest information on whooping cough can be found on the California Department of Public Health webpage.