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Published Date: 2012-07-18 13:53:51
Subject: PRO/EDR> Pertussis - USA (12)
Archive Number: 20120718.1204697

PERTUSSIS - USA (12)
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In this update:
[1] Oregon (Lake County)
[2] Nevada (Clark County)
[3] Washington State (Snohomish County)
[4] Washington State (Yakima County)
[5] New York (Steuben County)
[6] Minnesota (Olmstead County)
[7] Minnesota (Isanti County)
[8] Kentucky (Madison & Estill Counties)

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[1] Oregon (Lake County)
Date: Tue 10 Jul 2012
Source: The Register-Guard [edited]
http://www.registerguard.com/web/newslocalnews/28363316-41/health-county-cases-lane-pertussis.html.csp

As pertussis cases continue to climb in Oregon, Lane County health officials have decided it's time to sound the alarm with a town hall meeting. Pertussis is characterized by common cold symptoms that can evolve into severe, rapid coughing spells.

The infection is a growing concern for health officials in Oregon, who have seen a total of 458 reported cases through Friday, 6 Jul 2012, compared with just 147 by the same time in 2011. Infants younger than one account for 63 of those cases.

Only 10 of this year's [2012] cases have been reported in Lane County, but officials are concerned that the number could climb. Most of the local cases involve children; the mean age among the 10 cases is 8.

"We are not ready," Lane County Public Health Officer Patrick Luedtke said Monday [9 Jul 2012]. "The No. 1 prevention method is vaccination, and our vaccination rates are not high enough."

According to Luedtke, roughly 20 percent of Lane County children age 2 or younger are not vaccinated, about 3500 individuals. Infants younger than 3 months are particularly vulnerable because they are too young to be vaccinated and have not developed enough to properly handle the coughing fits, thus making it much more important for adults to be vaccinated to avoid passing the infection to infants, Luedtke said.

"Whooping cough kills babies, period," Luedtke said. "And some people don't know that."

According to state figures, Lane ranks the 3rd highest among Oregon counties with 8.5 percent of residents declining vaccination on religious or philosophical grounds, including those who have concerns about possible side effects of vaccination.

[Byline: Patrick Malee]

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[2] Nevada (Clark County)
Date: Wed 11 Jul 2012
Source: 8 News Now [edited]
http://www.8newsnow.com/story/18983109/health-district-reports-22-cases-of-pertussis

There have been 22 cases of pertussis reported in Clark County since the beginning of 2012, according to the Southern Nevada Health District. Seven of the cases were in children under the age of one. The health district is reminding parents, health care providers, and child care providers to receive the vaccine.

Children attending school in Clark County must be [fully] immunized before they can attend kindergarten and [again] prior to entering 7th grade.

[Byline: Caroline Bleakley]

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[3] Washington State (Snohomish County)
Date: Fri 13 Jul 2012
Source: Arlington (WA) Times [edited]
http://www.arlingtontimes.com/news/162396306.html

More than 2000 new cases of pertussis, also known as "whooping cough," have been reported [in Washington State] since the state Secretary of Health declared an epidemic on 3 Apr 2012. The epidemic is up to 2883 reported cases and remains active, especially in Snohomish County, as state health officials urge vaccination and other disease prevention measures.

"Infants are most at risk for very serious illness from whooping cough, and many are made sick by adults who don't know they're carrying the illness," state Health Officer Dr. Maxine Hayes said. "All teens and adults should get the Tdap shot. Even people who don't have close contact with babies can spread the illness to babies when they're in public."

As of Friday, 6 Jul 2012, the Snohomish Health District had confirmed 408 cases of pertussis in Snohomish County since the start of 2012. "This includes 6 hospitalizations, 5 of whom were infants," said Suzanne Pate, public information officer for the Snohomish Health District, who noted that no infants in the county have died from pertussis in 2012, but one infant did die of it in August 2011.

Babies younger than 2 months are not old enough to receive vaccinations and are at high risk for serious illnesses as a result. Statewide, there have been 173 reported cases of whooping cough among infants, 38 of whom were hospitalized.

Protection provided by the childhood whooping cough vaccine series wears off over time, so teens and adults need a booster. People whose vaccine protection wears off may contract whooping cough themselves, but usually suffer from less severe symptoms and shorter illnesses and are less likely to spread the disease to others. Adults who aren't sure whether they've had the Tdap booster should check with their health care providers.

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[4] Washington State (Yakima County)
Date: Thu 12 Jul 2012
Source: KIMA-TV [edited]
http://www.kimatv.com/home/video/250-reported-cases-of-Whooping-Cough-in-Yakima-County-162295826.html

The Washington State Department of Health reports more than 2000 new cases [of whooping cough] since April 2012. Washington only saw a fraction of that in all of 2011. In Yakima, the local health district reports roughly 250 cases. There weren't even 5 cases in all of last year [2011].

The health district says the vaccines should help uninsured families. In all, 14 000 doses are being sent across the state.

"Each county gets an allotment, and our providers are taking advantage of that, so that tells me they're using it," said Yakima Health District Community Health Director Sheryl Di Pietro.

[Byline: Michael Spears]

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[5] New York (Steuben County)
Date: Thu 12 Jul 2012
Source: Central NY [edited]
http://centralny.ynn.com/content/top_stories/591338/whooping-cough-problem-in-steuben-county/

Only about halfway through July 2012, and so far in 2012, there have been nearly 50 cases of pertussis, or whooping cough, in Steuben County. That compares to just one all of 2011.

County health officials say they aren't entirely sure why the outbreak has occurred but want people to be on the lookout for the signs and symptoms. In adults, whooping cough can appear as the common cold or sinus allergies but is much more serious if contracted by children. About half all of infants who get whooping cough end up in the hospital.

[Byline: Bill Mich]

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[6] Minnesota (Olmstead County)
Date: Fri 13 Jul 2012
Source: My Fox 47 [edited]
http://www.myfox47.com/story/18964061/pertussis-still-a-threat-in-olmsted-county

Pertussis continues to be a problem across Olmsted County. In fact, just in the 1st half of 2012, the county has had 5 times as many cases as in all of 2011.

Pertussis will typically peak every 3 to 5 years. While 2012 has been a peak year, it's unique in that the county is still seeing growing numbers of cases this far into summer.

98 cases have been reported this year [2012] in Olmsted County, and the pattern is similar across Minnesota. According to Public Health, there's reason to believe many people are spreading the disease, and they don't even know they have it.

"I do believe there are many people in the community that are unaware of the outbreak of pertussis but also about what the symptoms are," said Linda Haeussinger of Olmsted County Public Health. "The primary symptom of pertussis is coughing, and we cough for many reasons, bronchitis, pneumonia, allergies, etc."

Fewer than 10 percent of adults across the country are vaccinated against the disease. That's currently considered the best method of prevention among health professionals.

[Byline: Aubrey Helms]

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[7] Minnesota (Isanti County)
Date: Tue 11 Jul 2012
Source: Isanti County News [edited]
http://isanticountynews.com/2012/07/11/whooping-cough-is-making-rounds-again-in-isanti-county/

Pertussis, more commonly known as whooping cough, is back as a distinct medical concern, with 14 cases in Isanti County since 1 May 2012, reported Public Health Director Kathy Minkler at the 5 Jul 2012 Isanti County Board meeting.

"The biggest concern with pertussis is to protect infants in homes that have been infected, since they can have the most complications with the illness, which include seizures, inflammation of the brain and even death," warned Minkler.

She said most of the Isanti County pertussis cases have been among middle school aged children, including 2 that were found in swimming classes. She added that Minnesota is 2nd to California in whooping cough cases in 2012. The bacterial disease, spread person to person through the air, goes in outbreak cycles between 7 to 10 years.

Minkler added that there has been a drop in the pertussis immunization rate this year [2012], perhaps fueled by a fear from side effect reactions. But a new form of the Tdap vaccine was developed over the past 10 years which is showing fewer reactions, Minkler said.

[Byline: Greg Hunt]

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[8] Kentucky (Madison & Estill Counties)
Date: Thu 12 Jul 2012
Source: WTVQ [edited]
http://www.wtvq.com/content/localnews/story/Whooping-Cough-Outbreak/QkovC9ZzxUm3brdC7gG9rQ.cspx

The USA is on course for a record year for pertussis, more commonly known as whooping cough, and there are outbreaks being reported tonight in parts of our viewing area.

More than a dozen cases in recent weeks have been reported in Madison and Estill Counties, according to the respective health departments there.

"We've never had this many cases over the last 5 years," Judy Collins, Bluegrass Region Epidemiologist says. "We're in the double digits now, so it's above and beyond what we would normally expect for this time of the year."

[Byline: Ellen Bryan]

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In previous postings on pertussis, ProMED has highlighted research by both Dr Frits R Mooi from the Netherlands (Pertussis - Australia (04): newly emerging clones, discussion 20120322.1078115) and Dr Lyn Gilbert from Australia (Pertussis - Australia (03): newly emerging clones 20120321.1076103) that has been reflecting antigenic changes in circulating clones of _Bordetella pertussis_, which may be causing the increased number of pertussis cases throughout the world. A recent in-press paper from the CDC (1) has also addressed these antigenic changes and also found the predominance of the fim3B allele but concluded that: "The changes in vaccine composition and schedule were not the direct selection pressures that resulted in allele changes present in the current _B. pertussis_ population."

Another recent paper from the CDC (2) discusses the apparent quicker wane in immunity against pertussis with the acellular vaccine and potential options, including an intranasal, live, attenuated _B. pertussis_ strain (3).

References:
1. Schmidtke AJ, Boney KO, Martin SW, et al: Population diversity among _Bordetella pertussis_ isolates, United States, 1935-2009. Emerg Infect Dis (in press); http:wwwnc.cdc.gov/eid/article/18/8/12-0082_article.htm.
2. Clark TA, Messonnier NE, Hadler SC: Pertussis control: time for something new? Trends Microbiol. 2012;20: 211-213.
3. Feunou PF, Kammoun H, Debrie AS, Mielcarek N, Locht C: Long-term immunity against pertussis induced by a single nasal administration of live attenuated B. pertussis BPZE1. Vaccine. 2010;28: 7047-7053. - Mod.LL]

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