http://seattlepi.nwsource.com/local/128965_cough01.html

Tuesday, July 1, 2003

Cases of whooping cough surge
King County says vaccine may wane at middle school age, aiding outbreak

By MARY VUONG
SEATTLE POST-INTELLIGENCER REPORTER

Reported cases of whooping cough in King County children have soared since last year, the health department announced yesterday.

So far this year, 81 cases have been reported in children younger than 18, compared with 86 cases for all of last year. Overall, the county has recorded 118 cases to date, with no deaths.

Also called pertussis, the highly contagious bacterial disease incites a "whooping" sound with coughs and can occur at any age, although the effects are most severe in children younger than 1 year old.

It is spread through contact with infected people.

Because symptoms can be difficult to detect in infants, parents should alert the physician when a sick child has been in contact with a coughing person.

Young children who have not been immunized face a higher risk.

This year, 17 cases in infants 6 months old or younger have already surfaced in the county. A dozen were reported all of last year.

"I can't say that I can identify one specific reason" for the increase, said Chas DeBolt, vaccine-preventable diseases epidemiologist at Public Health -- Seattle & King County.

She suggested that several large outbreaks involving middle-school students occurred because the vaccine's effectiveness begins to wane around that age.

Pierce County also recently reported a rise in pertussis.

The number of cases quadrupled to an average of 12.3 per month from November 2002 to May 2003.

Washington recorded 205 cases as of mid-June, compared to 243 cases at the end of June 2002. It counted 574 cases in 2002. This year, it ranks as the 11th highest in the nation among incidence of reported pertussis.

"Pierce and King (counties) are seeing more cases without a doubt," said Tim Church, spokesman for the state Department of Health. "The rest of the state, I'd be hard pressed to say there's a trend.

"It tends to go up and down."

The increase is part of a cyclical trend that spikes every three to four years, DeBolt said. More than 400 cases were reported in 1999.

"It is a continual process," DeBolt said. "When it gets started in a community, you have an upsurge. I don't think it ever goes away."

The health agency as well as Parents of Kids with Infectious Diseases, a nonprofit group, urge staying up-to-date on childhood immunizations.

"I believe we owe it to our communities to immunize our children, so we can protect their youngest, most vulnerable members," said spokeswoman Christine Kukka for Parents of Kids with Infectious Diseases.

The vaccine is usually given combined with tetanus and diphtheria as DTP vaccine (diphtheria, tetanus, pertussis).

It is recommended to be given as a course of five, at the following ages; 2 months, 4 months, 6 months, 12-18 months and 4-6 years.

THE SYMPTOMS

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