Whooping cough ‘epidemic’ hits 21 confirmed cases; several hundred persons evaluated with disease

Return to Vaccination News Home Page __» Right-click to "open in new window"

Subscribe to the Vaccination NewsLetter

View past & current Scandals (columns by Sandy Mintz)

http://www.zwire.com/site/news.cfm?newsid=8760475&BRD=2081&PAG=461&dept_id=385210&rfi=8

Whooping cough ‘epidemic’ hits 21 confirmed cases; several hundred persons evaluated with disease

By Tommy Howard, staff writer

June 27, 2003

Health officials confirmed Thursday that an epidemic of whooping cough has hit Georgetown County.
At least 21 confirmed cases have been reported to the state Department of Health and Environmental Control and another six have been identified as probable.
An additional 200 persons have been evaluated by doctors and advised to closely monitor their symptoms for several weeks and more than 50 additional children and adults were provided with PEP (Post-Exposure Prophylaxis), a preventive antibiotic with erythromycin.
Dr. Robert Ball is a specialist with infectious diseases and an epidemiologist with the state Department of Health and Environmental Control (DHEC). He works with the Waccamaw (Georgetown, Horry and Williamsburg counties) and Trident (Charleston, Berkeley and Dorchester counties) public health districts.
He confirmed that the number of cases in the area qualifies for the term, “epidemic.”
Whooping cough or pertussis is the “P” of DPT. That’s the series of vaccinations that little children start when they are just a couple of months old, and complete the series of (usually) five immunizations or shots before entering school. A newer version of the vaccine is called DTaP.
The outbreak has been going on since early May and involves a middle school, a high school, a cosmetology school and now, Ball added, four day-care centers, in which the infants and toddlers are at special risks for complications of pertussis.
He dismissed rumors that students from Waccamaw High School brought the disease back with them when they took a cruise this spring. Ball said they were just among the early cases.
“Pertussis occurs sporadically each month in the community anyway,” he said. “There would be a few cases here and there in various places in South Carolina.”

Large case increase

Across South Carolina, 179 cases of pertussis or whooping cough were reported over the last five years to the national Centers for Disease Control.
Dr. Eric Brenner, an epidemiologist with DHEC’s Columbia office, said in 2002 the Waccamaw Health District reported two cases each in Georgetown and Horry counties, and none that year in Williamsburg County.
“Your part of the state is having its biggest outbreak of pertussis in the last half-dozen years, if not more,” Brenner said. “I know they’re having their hands full.”
Ball said the number of cases of whooping cough in a short time qualifies this as an “epidemic.”
The 21 confirmed cases, along with the probable cases and the people undergoing treatment, have all occurred in a relatively short time period — May and June. They are mostly confined to Georgetown County, and the people involved have had contact with other people who previously had pertussis.
“An ‘outbreak’ is a small increase, while an ‘epidemic’ is a large increase,” Ball said.
He praised Dr. Paul Hletko of Pawleys Island for his recognition of whooping cough in one of the earliest cases.
“He has been an invaluable colleague in this, he and his nurses,” Ball said.
DHEC is working closely with the medical community in Georgetown County, Ball said. Local health-care providers are helping identify cases and contacts and assist or provide testing, treatment and prophylaxis, he said.
He suggested that people who want further information should call the Waccamaw Health District at (843) 365-3126.

Symptoms

In most adult cases, Ball said, pertussis causes a new or different chronic-cough illness lasting two or more weeks. The cough is usually dry, hacking and often followed by vomiting, gagging and sometimes the characteristic whoop (as you catch your breath, you get an inspiratory whoop).
“For small children, the illness can be much worse and have serious complications, including seizures, pneumonia, encephalothopy (brain swelling) and even death,” he said. “The mortality rate is relatively low.”
Fever occurs in little children occasionally, but that is variable.
“Usually, there is no shortness of breath, no fever, pneumonia or flu-like symptoms, just a cough illness.
“The characteristics and duration of the cough illness easily separate it from a common head or chest cold,” Ball said. “Most adults don’t complain of shortness of breath.”
While the DTaP vaccine is effective, it could be better, Brenner said.
He said whooping cough or pertussis is “something maybe our grandparents knew a lot about. In the old days, it was a very common childhood disease.”
South Carolina has about 55,000 births every year. The total number of pertussis cases in the state is very small, just in the hundreds.
“Pertussis vaccines helps with control, but hasn’t eliminated it,” he said.
Even though doctors and health departments provide very good vaccine coverage, there are still some cases of the illness.
The tetanus vaccine is very effective, Brenner said, but pertussis doesn’t work as well.
“What society really needs is an improved vaccine that will be safe and effective in older kids,” he said. “We have good tools, but not perfect tools. (The vaccine) has decreased cases and deaths by about 95 percent.
“Measles is gone in South Carolina, yet we still have pertussis. We are using an improved vaccine now, compared to the one used in ’40s and ’50s,” Brenner said.
That all points out the need for parents to ensure their children get the DTaP shots according to the recommended schedule, so the immunization can help.
“Pertussis seems to be cyclical,” Brenner continued. “Certainly in your part of the state, you are headed for a big pertussis spring.”
“What folks in your part of the state are doing is a lot of contacts tracing,” he said.
“Having kids have their shots on time is important,” Brenner stated.
Pertussis vaccine provides protection after the child gets the first three or four vaccines.
The problem is severe in little kids, under one year of age, he said.
“If they are exposed, most kids will be protected. Some will be partially protected, but won’t get as severe a case of pertussis. And some won’t be protected,” Brenner said, “which is why we still have kids with the disease.”

Contact Tommy Howard by e-mail at thoward@gtowntimes.com or by telephone at 546-4148, ext. 230.

Return to Vaccination News Home Page __» Right-click to "open in new window"

DISCLAIMER: All information, data, and material contained, presented, or provided here is for general information purposes only and is not to be construed as reflecting the knowledge or opinions of the publisher, and is not to be construed or intended as providing medical or legal advice. The decision whether or not to vaccinate is an important and complex issue and should be made by you, and you alone, in consultation with your health care provider.