News

Whooping cough epidemic hits California

Disease can be deadly in infants; county officials urge vaccination in children and adults in contact with the young

Whooping cough, a serious bacterial disease that can cause severe illness and death in infants, is epidemic in California according to state and local health officials. County health officials are saying people should get vaccinations and booster shots.

As of June 25, whooping cough, which is also called pertussis, has been verified in 41 cases in Santa Clara County, according to Joy Alexiou, county health spokeswoman.

At the same time last year, only nine cases were reported and only 25 cases were reported for all of 2009. Statewide, 910 cases of whooping cough have been reported, up from 219 from this time last year, Alexiou said.

Surges of whooping cough infections are somewhat cyclical and occur once every several years, she said. Palo Alto has been fortunate and has had only one case so far. That person is a 16-year-old, she said.

Whooping cough gets its name from the sound associated with the severe cough it causes. Infected individuals may make a whooping sound as they gasp for breath in the midst of severe coughing spells.

To hear what whooping cough sounds like in a child and adult, visit the Santa Clara County website.

People often do not realize they have whooping cough, as the symptoms are similar to those of a common cold: runny nose, sneezing, low-grade fever and coughing. But unlike a cold, pertussis is bacterial, not viral. The cough it causes is much more severe and can lead to death in infants, Alexiou said.

In infants, usually there is no fever and diagnosis can be missed because initially symptoms can be mild. But the cough can be mild and then transform into severe respiratory distress, according to San Mateo County health officials.

There is no lifetime immunity from the disease and nearly half of all infants get whooping cough from their parents, officials said.

Anyone who will come in contact with an infant -- including grandparents, parents, siblings and child-care providers -- should be vaccinated, county officials said.

Pregnant women may be vaccinated during the last three months of pregnancy (third trimester) or after giving birth. Fathers can be vaccinated at any time but it is better at least two weeks before the baby's birth, according to San Mateo County officials.

Children under the age of 1 are particularly vulnerable since the regimen of vaccines that protect against the disease isn't completed.

Infants cannot begin the vaccination process until they are 2 months old but are at risk until they receive two more shots at ages 4 months and 6 months. Two more booster shots are recommended at 15 to 18 months of age and at age 5 to maintain protection.

Adolescents and adults comprise 27 percent of reported cases -- infants comprise the majority of reported cases. Persons who have previously contracted the disease lose immunity in about 15 years, while immunity from vaccinations wanes 5 to 10 years after receiving the vaccination series.

Most cases in adults remain undiagnosed and are often mistaken for asthma or bronchitis. Adults might report sweating or a sensation of choking. Adults and adolescents with a cough lasting more than two weeks should be considered for whooping cough, according to the San Mateo advisory.

Healthy adults who contract the illness are likely to develop a severe cough after cold-like symptoms subside, but will be able to get well without medical intervention, according to Dr. Marty Fenstersheib, a health officer for Santa Clara County.

Anyone with a compromised immune system or respiratory problems will be more vulnerable to complications from whooping cough. The illness can be spread through the air and picked up by touching surfaces contaminated with the bacteria, Fenstersheib said.

Whooping cough can be treated with antibiotics, which will help cut down on an individual's infection, but even with treatment the cough is often persistent, he said.

Alexiou said there is adequate supply of pertussis vaccine to go around and that those interested in receiving the vaccine will be able to get one through county health services and private providers.

Santa Clara County health officials are working with the medical community at hospitals and clinics to vaccinate pregnant women and infants who are most vulnerable, she said.

People who cannot afford the vaccinations can receive one from Santa Clara County. A list of health providers and further information is available online at the county website.

Health officials in San Mateo County released a press release on Thursday (July 1) regarding a comprehensive outreach program to protect residents.

Information about the vaccine will be provided to health care providers, departments serving families of newborns and young children, school nurses, administrators and teachers, new parents at birthing and infant-care classes and to parents picking up birth certificates at the Vital Statistics office.

The San Mateo County Health System will partner with local schools to encourage middle-school students to get booster shots between ages 10 and 12. Child-care workers are encouraged to get a booster shot every 10 years.

San Mateo County residents can find more information and a list of health care providers giving vaccines at www.smhealth.org/pertussis.

Alexiou pointed to the "same old" methods for preventing any contagious disease to help prevent pertussis.

"Cover your cough, wash your hands, and stay home when you're sick. It's boring but it works," she said.

Comments

Like this comment
Posted by Cautious Parent
a resident of Another Palo Alto neighborhood
on Jul 2, 2010 at 10:41 am

I refused to let my children have the "P" part of the DPT vaccination when they were small. At the time the "P" part of that vaccination (to prevent pertussis) was associated with a certain number of children developing lifelong health challenges (don't remember exactly what those were.....maybe paralysis). I weighed the likelihood of my kids developing whooping cough and any life-long consequences of fighting off that disease (my niece had it as a girl and suffered no life-long side effects nor did she die). I decided that I would rather not risk the horrid side effects that could happen if my child just happened to be that one in ???,000 kids that would have a negative reaction as a result of the vaccination. There is plenty of information out there about the dangers of vaccinations in the internet and I would advise parents to do your research before just going out and getting their child vaccinated against every potential disease on this planet. Be an informed medical consumer. Your children rely on you to make the very best decisions concerning their health care options.


Like this comment
Posted by Gander
a resident of Barron Park
on Jul 2, 2010 at 1:01 pm

Cautious,

Yes, you "weighed the likelihood," which is quite low because other parent vaccinated their kids. In other words, you are relying on others to vaccinate their kids so that you don't need to. How low. I wish the government would bar your kids from school.

In any case, the movement away from vaccines by some parents is extremely irrational.


Like this comment
Posted by Me Too
a resident of Midtown
on Jul 2, 2010 at 1:16 pm

Actually Gander, I think it is in fact rational - so long as the vast majority of others do get vaccinated. If, like Cautious, you can be a free rider, avoid the risk of the vaccine but get the benefit of "herd immunity" - you win! The problem is that if every one catches on, we lose herd immunity and all suffer.

Cautious, maybe you were a clever parent - or maybe just a selfish and short-sighted one. We'll see.

Probably we will need regs to enforce vaccination regimes - otherwise we all will suffer.


Like this comment
Posted by Gander
a resident of Barron Park
on Jul 2, 2010 at 6:10 pm

Me Too,

The risk from vaccines is vastly overblown among the superstitious. In almost all cases, it makes sense to vaccinate, even taking into account the assumption that almost all will vaccinate. Vaccination rates have, in fact, dipped in various first-world regions for certain vaccine-preventable diseases that still circulate in the first world at low rates and in the third world at higher rates (don't forget airplanes).

There is an additional risk that others take the same wrong-headed approach.

Apart from that, there is, of course the moral implication of being a free rider. I say ban those kids from school. Why should our kids be exposed to that risk?


Like this comment
Posted by Perspective
a resident of Meadow Park
on Jul 4, 2010 at 6:29 am

All I know is this..I had whooping cough, as did my teen son, 4 years ago, before we knew we needed to get RE-vaccinated as teens to prevent it.

This is not something I would risk for anyone. Literally coughing until you puke for 3 months is NOT a healthy alternative. Took 2 years for each of us to recover our ability to breathe normally in exercise without steroids, or have a cold and not have a lingering awful cough, and have to use steroids for stress-induced reactive "asthma"

Don't risk it. It is foolish to risk a disease which, if it doesn't kill you, can so severely disable you. How silly. No data at all to support Gander's concern. Not at all. Same thinking that says a "car" is a safer than a "plane", though 50,000/year die from car accidents, and how many from plane accidents?

Don't do it.


Like this comment
Posted by Gander
a resident of Barron Park
on Jul 4, 2010 at 9:24 am

So far, five infants too young to be vaccinated have died in this California epidemic.

I invite Cautious to write a letter to the families of those five explaining why it was such a good trade-off in terms of risk for his or her children versus for other children.


Like this comment
Posted by Keri
a resident of Palo Alto High School
on Jul 5, 2010 at 12:12 am

@Perspective: Thank you for the helpful anecdote. Didn't realize it would be that bad.

They ban kids from school if they do not have certain vaccines. They should ban kids if they do not have whooping cough boosters.

First poster, "Cautious parent" may have physically healthy children but I question if they are mentally healthy with a mom as such.


Like this comment
Posted by Pro-arizonia
a resident of Menlo Park
on Jul 5, 2010 at 12:10 pm

The big picture is the actions by entities like, "ARIZONA LAWS",...that protect US,....or USA citizens from unvaccinated persons,...and later cost the tax payer even more after illegal immigrants settle in.


Like this comment
Posted by mmmmMom
a resident of Downtown North
on Jul 6, 2010 at 1:56 am

Geez, people!
Just because you do not agree with Cautious Parent does not give you the right to be rude, and/or resort to name-calling. Although my kids received 90% of the recommended vaccinations (although not necessarily in the usual time frame), I can certainly respect parents who chose to do all or none.

Remember, this is a free country, & no one can be forced to undergo any medical procedure - including vaccinations - against their will.

If you really, truly cared about the health of our community's & our nation's children, you would be working for exclusive breastfeeding for all children - until one year of age. That is the official policy of the American Academy of Pediatrics, the same group that sets vaccination schedules.


Like this comment
Posted by Perspective
a resident of Meadow Park
on Jul 6, 2010 at 6:56 am

Well..actually..yes, actions by some which endanger us all ARE an open invitation to public scrutiny and cold shoulder/rudeness ( since we can't cold shoulder in person).

So, I disagree with you mmmmMom. We have to speak up forcefully in the face of societal dangers. From the beginning of time peer pressure has helped shaped societal behaviors, and the societal behaviors expected of each of us were thought to be behaviors good for the whole.

This is, indeed, a free society..we are free to act as we please, free to reap the consequences of our actions, fee to pay the price of our actions and not expect others to pick up the pieces for us, and free to condemn others for their actions that affect innocent people.

Breast feed all you want, nobody cares..by the same token, nobody can force anyone else to "exclusively" nurse until one year's age. BTW, in nations where nothing else but mother's milk is available to kids, I note that there are still horrific numbers of deaths from from unvaccinated children, so it is not clear to me about your point related to Whooping Cough vaccinations.

Go get vaccinated..it really is not worth the risk to yourselves ( or others).

to the "Thanks for the anecdotal" person..you are more than welcome. The only good thing about us having gone through that is that we are now "vaccinated" by fire..oh..and I guess another good thing is that maybe our story helps others not make the same mistake ( not get revaccinated as a teen).






Like this comment
Posted by Keri
a resident of Palo Alto High School
on Jul 6, 2010 at 8:55 am

@mmmMom: I am a long-time breastfeeder (till age 3) and agree that breastfeeding is best for children but it's the parent's decision whether or not they want the positive health benefits for their children and it does not affect anyone else. There is no way to force moms to breastfeed; even pulling formulas from shelves wouldn't work. Parents not vaccinating their children CAN AFFECT others so it should be mandatory.

@Perspective: Thanks, your posting did make me check my kids' vaccinations. Kids usually get re-vaccinated at age 11 and the booster lasts 7-10 years.


Like this comment
Posted by mmmmMom
a resident of Downtown North
on Jul 16, 2010 at 10:52 am

Actually, Keri, breastfeeding one's child DOES have lots of impact on the community at large. To begin with, breastfed infants & children have less illness, which means that they are not therefore going to pass on their illness to anyone else. Also importantly, breastfeed gives excellent immunity to infants too young to be given the first immunization shots, & provides antibody specific immunity during any illness. Breastfed children also go on in life to have less obesity, diabetes, cancer, etc - which greatly impacts health care dollars for all of us. More emphatically, my point is that instead of condemning someone else's free choice (and remember, in this country it IS a matter of choice), all that energy would be better spent in advocating for full breastfeeding for one year; which is the standard set by the American Academy of Pediatrics, & rarely followed in this country.

If you, or anyone else, is immunizing your children, then why are you so bent out of shape about someone else's decision? It is their children who are at risk during an increase, or an epidemic, in a childhood disease. You also have to recognize that those people who do not vaccinate their children are not the majority.

And to anyone who thinks that those parents deserve anything less than complete, ordinary respect, let alone "cold shoulders" marginalization, that kind of fascist thinking does not warrant comment here.


Like this comment
Posted by Gander
a resident of Barron Park
on Jul 16, 2010 at 3:07 pm

mmmmMom,

You are the one who seems bent out of shape.

First, you clearly don't understand vaccination. It does not confer 100% immunity, so by not vaccinating your children, you are increasing the risk for immunized kids in whom the vaccine did not take.

Second, it makes complete sense to ostracize those who put other children at risk. How would you react if someone sent their kid over to your house scratching with lice? Allow the kid to play with your child or send him/her home?

If you "respect" the decision to not vaccinate, perhaps you could draft the letter for Cautious to the parents of the infants who have died in this epidemic explaining why.


Like this comment
Posted by mmmmMom
a resident of Downtown North
on Jul 17, 2010 at 12:19 am

Gander, I am a healthcare professional, & DO understand vaccinations.

You are obviously not a professional, so I won't get too technical on you, but to use your own flawed example, a child with lice showing up for a playdate has what we call an "acute" condition. Sick people, kids or adults, should stay @ home. This thread is about the state of immunity conferred by vaccination - & the risk to others from those chosing not to be vaccinated - not the state of being ill. Two people, of any age, can be live, play, &/or work together, one protected by immunization & the other at risk by not being vaccinated. When exposed to a disease, risk ratios will come into play. Of course, vaccinations are not 100% guaranteed (I never said they were) . But they do work, which is why those of us who trust that fact do immunize our children & ourselves.

Talk to your primary care provider about this. And please be sure to mention your theory of ostracizing children not vaccinated. I'm quite certain you will not agree with your physician's response, since it will sound very much like mine.



Like this comment
Posted by Me Too
a resident of Midtown
on Jul 17, 2010 at 8:17 am

In my life experience, when people play the "I'm a professional" card, it usually means watch out for the snakeoil.

I'm not sure if I agree with Gander or not in this case, but his response seems reasonable. If you think high compliance with vaccination is importance for "herd health" and some people want to be "free riders," foregoing vaccination for their kids depending in part on the fact that most others get vaccinated, then peer pressure on the parents is a reasonable response. Personally I don't like free riders much, though I'm not thrilled about the vaccination regime in the US either. But when vaccination levels start to dip below a tipping point (90%? not sure), it is time to worry and maybe do something.

So Gander, stick to your guns. Watch out for those "professional opinions" ;-)


Like this comment
Posted by Gander
a resident of Barron Park
on Jul 17, 2010 at 9:04 am

mmmmMom,

If you understand that vaccination does not confer 100% immunity, then you should also understand that you were wrong to say it is only children whose parents chose not to vaccinate who are at risk during an epidemic. You left out those in whom the vaccine did not take. And those who have not completed the series of vaccines. And those who cannot have the vaccine, such as infants. (Still waiting for your letter to the parents of the dead infants.)

Your claim that those who do not vaccinate their children are not in the majority is deeply misleading. This is technically true, but irrelevant. Even relatively small pools of unvaccinated create large risks for others. Public health officials and epidemiologists do, in fact, worry about these pools and have been sounding the warning for some years about these people, who are termed "parasites."

But you didn't follow the other part of the thread here about ostracizing at all. The point is not that you will prevent your child from catching whooping cough on a particular day but that if enough people do the same (and if schools act in the same way) you will in effect rebuke parents into vaccinating their kids, thus promoting health broadly.

You misunderstood because you are narrowly focused on selfish benefits. Ostracizing, in this case, promotes a healthy society with strong community values.

If schools didn't screen (and ostracize) kids for lice, some parents would send their kids in with lice. But since that example confused you, think of it this way. If someone was urinating in the public shower at the Y, you would rebuke them even if they were not splashing you. Why? Because you are looking out for the greater good and not just your selfish interests.


Like this comment
Posted by Perspective
a resident of Greenmeadow
on Jul 17, 2010 at 10:24 am

Well said, Gander.

BTW, I agree with the "I am a professional, so..." leading to automatic suspicion on my part. Too much ego tied up in the followthrough. Or, unable to use facts and logic, so falls on "professional".

A true professional need not trumpet "credentials", just speak humbly, logically and factually within his or her knowledge base.

Magically, credibility appears.


Like this comment
Posted by mmmmMom
a resident of Downtown North
on Jul 17, 2010 at 3:47 pm

Whoa!
A wee bit sensitive as well as misinformed, I see. So sorry that you are afraid of healthcare professionals & evidence based statements.

Your diatribes are not worthy of considered response; I will merely re-state my previous suggestion. SPEAK TO YOUR OWN PRIMARY CARE PHYSICIAN ABOUT THIS TOPIC, & BE SURE TO MENTION YOUR APPROVAL OF SHUNNING CHILDREN NOT VACCINATED.

Gee, wish I could be a fly on that wall.......
Good luck, fellas.


Like this comment
Posted by Me Too
a resident of Midtown
on Jul 17, 2010 at 4:36 pm

1. "Trust me, I'm a professional"

2. "Your argument is not worthy of an answer"

Hmmm. Not a lot of evidence there.


Like this comment
Posted by Another Healthcare Professional
a resident of Old Palo Alto
on Jul 18, 2010 at 4:35 pm

mmmmmMom, I am a PNP (MSN)in town, and appreciate your perspective. Naturally, I am in complete agreement with your basic points. I was going to post a statement in response to the horrible comments posted, but you beat me to it and handled it well.

I can not say I was shocked at all the self rightous anger, as it has become the norm here. It is, indeed, why I only follow the Schools and Kids section. I do hope you will continue to add intelligence to this section. Thank you.


Like this comment
Posted by Me Too
a resident of Midtown
on Jul 18, 2010 at 4:46 pm

Disagreement does not equal anger or self-righteousness. I looked at Gander's posts again and couldn't figure out what part was supposed to be angry. He just disagrees and makes an argument, which the "professionals" don't rebut, they simply call him "sensitive," "misinformed," and "horrible."

Professions of all kinds have a way of developing a "received wisdom" which practitioners know and accept, even if they haven't thought it through themselves. "Self esteem" was/is one in the teaching profession, for instance. It can be dead wrong, but most folks don't question it or think it through, and tend to tut-tut those who do as unsophisticated.

Gander, stick to your guns. Again, I don't fully agree with your argument, but I like the way you think and argue, and I believe you are closer to the truth than the "professionals" on this one.


Sorry, but further commenting on this topic has been closed.

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