Wickford Middle School Student Sickened by Pertussis

School officials notified parents of children who attend Wickford Middle School that a sixth grader was sickened by pertussis recently and reminded families to get booster shots as the childhood vaccine is usually worn out by adolescence.

In a letter to parents sent out last week, parents were notified that their children may have been exposed and told they should be aware of the symptoms of pertussis and when to keep a child home.

In an interview on Thursday, Superintendent Phil Auger said that the student has received treatment for the bacterial infection, also known as whooping cough, and a sibling has tested negative for the infection. He said it appears that the infection has not spread to any other children and the district is only aware of the one case at Wickford Middle School.

Auger said even though the pertussis case appears contained, parents were notified in an effort to ensure everyone is on the same page. It also provides an opportunity to educate parents on how to prevent the spread.

“When we have cases like this, we make sure the community is aware and informed,” Auger said.

Pertussis is best prevented by staying up to date with vaccinations. In childhood, children get the DTaP vaccine and a booster in adolescence, the Tdap.

The Tdap is now required for all children entering seventh grade because that’s about when the early childhood vaccine usually fades away.

In fact, most pertussis infections and outbreaks among school children occur at the middle school level and among children who received the early-childhood DTaP vaccine, which also prevents against tetanus and diptheria.

Though a healthy child can weather a bout with whooping cough, it is extremely dangerous for newborns and infants and can be fatal. The risk is compounded by a long incubation period that begins with cold-like symptoms that appear up to 10 days after exposure.

School and health officials worry that a sick middle schooler who could have had a booster shot might infect another child who goes home and brings it to a newborn.

Adults and relatives are also advised to get boosters when they expect to come in contact with young children.

The school district provided the following information to parents in the letter:

What should parents do?
If your child is coughing, please contact your child’s healthcare provider for evaluation
and testing for pertussis and bring this advisory with you. If the healthcare provider
thinks your child has pertussis and/or prescribes treatment, keep your child home from
school and all activities until he/she has completed five days of antibiotics (even if test
results are not back yet). If the healthcare provider does not suspect pertussis is the
cause of your child’s symptoms, your child may return to school and all other activities.
If your child is not coughing but DOES have a weakened immune system or DOES live
with a high risk individual (defined as an infant under 12 months, a pregnant woman in
her third trimester, or anyone with a weakened immune system), preventive antibiotics
are recommended for your child to prevent illness and to prevent pertussis from
spreading. To obtain preventive antibiotics for your child please contact your child’s
healthcare provider to share this advisory.
If your child is not coughing and DOES NOT have a weakened immune system and DOES
NOT live with a high risk individual as defined above, no preventive antibiotics are
recommended. Please continue to monitor your child for symptoms over the next three
weeks.

What should clinicians do?
For exposed patients who have been coughing for 21 days or less:
Collect nasopharyngeal swabs for pertussis PCR testing and culture. Call the RI State Lab
for testing supplies. Do not delay treatment with appropriate antibiotics while waiting for
laboratory results if there is if no alternative diagnosis. Strongly consider antibiotic
prophylaxis (prior to test results) for all household members if a pregnant woman, an infant
less than 12 months old, or anyone with a weakened immune system lives in the household.
For exposed patients who have been coughing for more than 21 days:
Testing for pertussis is not recommended. Testing after 3 weeks of cough is of limited
benefit since PCR and culture are only sensitive during the first 2-3 weeks of cough when
bacterial DNA is still present in the nasopharynx. The patient is no longer infectious and can
return to school/community/activities. Treatment is no longer necessary after 21 days, with
the following exceptions: infants and pregnant women in their third trimester should be
treated through 6 weeks after cough onset.

For all households:
Administer Tdap vaccine to contacts 11 years and older who have not been previously
vaccinated with Tdap. Administer age appropriate vaccinations for children less than 11
years of age according to the current schedule. Antibiotic treatment and/or prophylaxis can
be done at the same time as vaccination.
Additional clinical and laboratory guidance may be found at
http://health.ri.gov/publications/guidelines/treatmentmanagementandreporting/Pertussis.pdf
and on the CDC website at http://www.cdc.gov/pertussis.
If you have any questions, please call the school nurse, Martha McLaughlin at (401) 268-64