Re: CA: 2010 Whooping cough
Re: CA: 2010 Whooping cough
Whooping cough cases rise
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Doctor points to lack of vaccinations
By Ryan White
Marinscope Newspapers
Published: Wednesday, July 7, 2010 3:01 PM PDT
<!--[include_if_component:movie-file:1:incs/story/movie.inc]-->While it might sound like a malady from a bygone era, health officials say cases of whooping cough have reached epidemic levels across Marin County.
Whooping cough, so named for its characteristic long-lasting cough, can afflict all ages, but is particularly perilous, even fatal, for infants 6 months and younger.
Dr. Rachel Bauer, director of pediatrics for Prima Medical Group in Mill Valley, said she?s never seen this many cases of whooping cough, or pertussis, as it?s medically known.
?I?m seeing more whooping cough in one week than I have in my entire career,? Bauer said.
Whereas in years past Bauer said she would occasionally observe the bacterial infection in young babies, she has recently witnessed a rash of patients in the 5-10 age range recently, something previously unseen.
Dr. Fred Schwartz, Marin County public health officer, confirmed there have been a record number of whooping cough cases in 2010. As of June 30, the county had recorded 202 cases in 2010, Schwartz said.
The previous high was in 2006, when 45 cases were recorded. In 2009, there were 14.
?This outbreak seems to have peaked in the last week in May and first week in June,? Schwartz said. ?Since that time, the number of new onset cases has been dropping off. That doesn?t mean it?s over by any means,? he said, adding that a second wave of infections is still possible.
Of the Marin cases this year, 88 occurred in patients 5 to 10 years old; 72 cases occurred in the 11-17 age group and 23 cases were in patients 21 and older. None have been fatal but a 1-month-old was hospitalized before recovering.
According to Mark Barmore, director of student services for the Mill Valley School District, Park Elementary and Mill Valley Middle School were the two schools hardest hit by whooping cough in Mill Valley, although every school had cases. Barmore said his nurses told him that whooping cough had a bigger student impact than N1H1 flu cases this past school year.
Whooping cough can resemble a cold initially, although usually without a fever. Then comes the cough, which progressively worsens until, Schwartz said, a patient can be engulfed in ?paroxysms of coughing, sometimes followed even by vomiting.? Severe, prolonged coughing spells can make it difficult to breathe as well.
Standard treatment for whooping cough is a five-day round of antibiotics (usually erythromycin). Without those, a patient can remain contagious for several weeks. Even with antibiotics, doctors say the cough can drag on for 14 weeks.
?There is no effective symptomatic relief for whooping cough,? Bauer said.
Although the Marin outbreak may have peaked as the school year came to a close, Bauer remains very concerned for families with infants, since children under 6 months have yet to be vaccinated and lack fully developed immune systems.
?I?m telling my patients and friends, if it was my kid, I would not take an infant under 6 months into the public right now,? Bauer said. ?You can?t be too careful.?
According to Bauer, five infants under the age of 3 months have died in California this year from pertussis. The infection is often fatal for such young children.
One of the reasons whooping cough has been so prevalent among the older 5-10 year olds is that kids in that age range are in between booster shots (the next booster shot for pertussis typically occurs at age 11).
Waning immunity from the vaccine in this age range is a key reason for this latest outbreak in the grade-school age group, Schwartz said.
While Bauer also pointed to waning effectiveness of the vaccine between booster shots, she views the problem differently. ?The reason that Marin is specifically susceptible to this is because a significant number of patients in Marin are choosing not to vaccinate against the whooping cough.?
If enough parents don?t vaccinate their children, Bauer said, that increases the chance that even vaccinated children will be infected with whooping cough, as Marin?s ?herd immunity? is lowered and the infection becomes more prevalent.
?The recent rise in pertussis is a direct result of Marin losing its herd immunity,? she said.
Bauer has little patience for those who don?t vaccinate their kids owing to concerns over vaccine safety. ?There?s no medical basis for the reasons these people aren?t getting vaccinated,? she said, adding that she constantly hears such fears voiced in her practice.
?I feel like Marin for the first time has the opportunity to say we?re talking about all these things that aren?t real, and here?s something that is real,? Bauer said, referring to whooping cough. ?It?s really a teachable moment. It?s driving me nuts.?
Both Schwartz and Bauer urged parents or anyone experiencing whooping cough-like symptoms to visit a doctor. ?I would come in at the earliest sign of any cough,? Bauer said.
http://marinscope.com/articles/2010/07/07/twin_cities_times/news/doc4c33e47b191c0744261278.txt
