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 A newer version of
the vaccine is called DTaP.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.
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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.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"
