http://www.mailtribune.com/archive/2003/0722/local/stories/03local.htm

July 22, 2003

Pertussis remains persistent nemesis

By JONEL ALECCIA

Mail Tribune

As a serious pertussis outbreak reaches its peak season, state officials are recommending that babies in Jackson and two other Southern Oregon counties receive immunizations earlier and more frequently than usual.

Jackson and Klamath County health officials are considering whether to launch "accelerated" immunization schedules that would inoculate babies as young as six weeks. Lane County officials began the new program this week.

"The goal would be to prevent death and hospitalization to very young children," said Hilary Gillette, a nurse and coordinator of the Oregon Health Services Immunization Program.

Incidences of pertussis in the three counties are now about 11 times higher than the state and national average, Gillette said.

In Jackson County, 66 presumed and confirmed cases have been reported this year. In Lane County, there have been 102 cases, while Klamath County has seen 16.

Those numbers are all high in a state that typically sees only 70 pertussis cases each year.

"Certainly this is a big outbreak," said Yvonne Chilcoat, Jackson County communicable disease coordinator.

An 11-week-old Klamath Falls boy died this spring of pertussis, the state’s only reported fatality from the disease this year.

Chilcoat and other officials met Monday to discuss accelerated immunizations.

Under the plan, babies would receive pertussis vaccinations at 6, 10 and 14 weeks, with boosters at 12 and 14 months.

That’s earlier and more often than traditional pertussis immunizations, which are given at 2, 4 and 6 months, with boosters at 15 months and before entering school. The immunizations are typically given with inoculations against diphtheria and tetanus as well.

Before launching the program, Chilcoat said officials had to consider the effect on doctors’ offices and clinic staffs. Logistical demands of reviewing individual immunization records and getting parents to abide by new schedules could be difficult, she said.

But Lee Murdoch, a longtime Medford pediatrician, said the benefits to the new schedule would outweigh the drawbacks.

"The key would be to get people who aren’t immunized and those who are partially immunized," Murdoch said. "If we’re losing the battle, then, yes, it’s time to step it up."

Pertussis, commonly called "whooping cough," is a serious respiratory disease characterized by a high-pitched, gasping, lingering cough. It can be fatal, most often in very young children. Children older than 6 and adults who contract the disease become ill, but not so seriously.

"With the little bitty ones, they end up in the hospital and as a doctor you feel pretty helpless because there’s not much you can do about it," said Diane Williams, an Ashland pediatrician.

So far, most cases in Jackson County have come from areas outside of Ashland. Health officials are crossing their fingers, however, hoping that it doesn’t reach the city with the highest level of religious immunization exemptions in the state.

"Infectiously, it just hasn’t made it down here," Williams said. "If it does, I will see a lot more coughing children."

Many parents declined to immunize their children because of concerns about an older, "whole-cell" pertussis vaccines. New "acellular" pertussis vaccines have been associated with far fewer side effects, Williams said.

However, some parents continue to object to multiple vaccinations for very young babies. Instead, they prefer to keep their infants away from potentially contagious people and places until they’re older.

Immunization exemptions decrease what medical professionals refer to as "herd" immunity, or a community’s overall level of resistance to disease.

"It’s a matter of people relying on the immunity of others to protect them," said Betsy Meredith, a communicable disease nursing supervisor in Lane County.

Reach reporter JoNel Aleccia at 776-4465, or e-mail jaleccia@mailtribune.com

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