MI: Whooping cough

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Source: http://www.detnews.com/article/2009...ton-County-sees-spike-in-whooping-cough-cases

Monday, July 27, 2009
Livingston County sees spike in whooping cough cases
Valerie Olander / The Detroit News

Howell -- A recent outbreak of a highly communicable illness, preventable by vaccine, has caused Livingston County Department of Public Health to issue a health alert today.

Eight confirmed cases of pertussis, commonly known as whooping cough, have been identified in the county from June 29 through July 24, according to Medical Director Donald Lawrenchuk. Six of the cases were children between the ages of 5 and 17.

"Roughly we have about 10 cases per year, so this year we already have 18 with eight in the last month, so that's quite a jump," Lawrenchuk said.

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"What is the most disconcerting to us is that of the last six cases, five of the six had no previous vaccination," he said.

The Health Department is advising all concerned individuals to check their immunization status, as well as their children's.

In Michigan, laws mandate that all school-age children are immunized, however religious or personal waivers are granted. For older students and adults, the vaccine may have lost its effectiveness after 10 years, Lawrenchuk said.

"This is not something to take lightly. Although it is a bacterial disease and antibiotics are available ... it can last for many weeks with spasms and vomiting with the classic whoop," he said.

The respiratory disease can cause serious complications for infants whose lungs are not developed, he said.

Of the eight cases, two are siblings. The majority of those infected have no one point of contact. They reside in various areas within the county.

A single booster dose of the combination vaccine Tdap, for Tetanus, diphtheria and pertussis, is recommended for those ages 11-64 and five doses of a similar immunization, DTaP, is recommended for children under age 7.

Both DTaP and Tdap are available through the immunization clinic at the Livingston County Department of Public Health, 2300 E. Grand River, Howell. Clinic hours are 8:30 a.m. to 4:30 p.m. on Wednesdays with extended hours until 7 p.m. on the second and fourth Wednesdays of the month.

The cost of the vaccine varies depending on insurance status. No child will be denied state required immunizations due to inability to pay.

For more information, call (517) 546-9850 or visit www.lchd.org.

volander@detnews.com (734) 462-2203

 

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Re: MI: Whooping cough

Source: http://www.lansingstatejournal.com/article/20090804/NEWS01/908040328/1001/NEWS

Whooping cough cases on the rise in Michigan
Effect of vaccine wears off over time, expert says

Christine Rook ? clrook@lsj.com ? August 4, 2009 ? From Lansing State Journal

The number of potentially deadly whooping cough cases continues to climb, according to state health officials.

About 280 cases of the illness, also known as pertussis, were reported statewide in the first half of this year. That compares with 315 cases for all of 2008 and 292 in 2007, according to the Michigan Department of Community Health.

"Pertussis has been a real hard disease to get a handle on," said Joel Blostein, an epidemiologist with the state.

One confirmed case was discovered as recently as July 20 in Eaton County.

Ingham County had a case in April. Clinton County has not seen any cases this year.

Pertussis is an upper respiratory bacterial infection that can lead to a permanent seizure disorder, mental retardation and death in infants. It is preventable through vaccinations, according to the National Institutes of Health.
Health alert issued

The state hasn't seen a pertussis death since 2006, when two fatalities were reported. Still, the state last week issued a health alert about the rising number of cases.

Ingham County Health Department passed that information along to area health care providers, asking them to watch for patients with a persistent cough. That's a cough that has lasted three to four weeks.

"We do know (the illness) is around," said Marcus Cheatham, assistant deputy health officer for the Ingham County department. "And so they're on the lookout for it."
Vaccine wears off

Pertussis has become more persistent since the 1980s, according to the national Centers for Disease Control and Prevention in Atlanta. Although experts see cases in all age groups, much of that increase is occurring among adolescents and infants younger than 5 months.

In 2007, more than 10,000 people reportedly fell ill nationwide; 10 died.

The real issue, Blostein said, is that the effect of vaccination wears off over time; so adults who were vaccinated as children become vulnerable to the bacteria possibly as soon as five years after their last vaccine.

Booster shots weren't available for adolescents and adults until 2005, meaning that many adults even now have no protection against the bacteria.
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And the risk to them is not the issue. It is infants under 6 months of age who are vulnerable.
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"Kids under the age of 6 months have an unpredictable response to immunizations," said Dr. Robert Schirmer, medical director for the Barry-Eaton District Health Department.

So even though infants in the U.S. begin their pertussis vaccination series at 2 months old, the protection may not be in place for them.
Complex issue

And pertussis is complicated - at least how it moves through a population.

Experts say it runs in 3- to 5-year cycles.

"We think we're in one of those," Blostein said.

That may explain the recent rise in cases and a spike back in 2006 when 632 cases were reported in Michigan. The following year, there were only 292 cases.

The complexity of pertussis doesn't end there. Health officials no longer see the disease as a childhood illness. They realize that children are being infected by adults who no longer have proper immunity.

"Part of the strategy has to be not only immunizing infants but immunizing adolescents and adults," Blostein said.

And the evolving views of health officials also may help explain some of the peaks and valleys in year-over-year data, showing the number of cases.

"There has been a lot that was unrecognized and unreported," Blostein said.

The solution, officials say, is for adults who are re-upping their tetanus vaccine to make sure their physician also is giving them the pertussis booster.

And families who don't have health insurance are encouraged to ask their local health department for information on possibly qualifying for free or discounted vaccines, officials say.

Michigan's sour economy has potential to inhibit the fight against the illness, said Dr. Robert Graham, medical director of the Mid-Michigan District Health Department, which covers Clinton County.

"Preventative services," he said, "take a back seat to acute services."

 

[Shiloh]

Re: MI: Whooping cough

Source: http://www.connectmidmichigan.com/news/news_story.aspx?id=335674

MI sees rise in whooping cough

Tuesday, August 11, 2009 at 11:04 a.m.

LANSING -- The following is a message from the Michigan Department of Community Health:

As Michigan continues to see a high level of reported pertussis (whooping cough) cases in 2009, extending a trend noticed in the second half of 2008, health officials are reminding parents and doctors of the importance of vaccinating children, teens, and adults against this serious disease.

"This disease continues to challenge us," said Michigan Department of Community Health (MDCH) Director Janet Olszewski. "But we have new tools and strategies to help us in our prevention efforts."

In 2005, new pertussis vaccines for adolescents and adults were licensed. Prior to that, pertussis vaccines were available only for children less than 7 years of age, which left teens and adults at risk because immunity against the disease can weaken and disappear over time.

In the first half of 2009, 281 pertussis cases were reported. That compares to 315 cases in 2008, two-thirds of which came in the second half of the year. In 2007 there were 292 pertussis cases reported in Michigan.

"Pertussis is a bacterial respiratory infection that can occur in all ages," said Dr. Greg Holzman, chief medical executive for MDCH.

"Babies are most severely affected. They?re the ones at greatest risk of a complicated case of the illness, often requiring hospitalization and sometimes resulting in death. That?s why it is absolutely critical that children get all their vaccine doses on schedule to give them as much protection as possible. It?s also important that family members of young babies get a pertussis vaccine booster so they are protected from illness, and don?t pass the illness to infants."

Holzman noted a recent study published in the June issue of the journal Pediatrics which found that children of parents who refuse vaccines are 23 times more likely to get whooping cough compared to fully immunized children.

Another study published on Oct. 11, 2006 in the Journal of the American Medical Association (JAMA) also documented an increased level of the disease among children whose parents opted not to have them vaccinated against pertussis.

Infants should receive four doses of pertussis vaccine by the time they are 18 months old, and a routine booster dose is recommended for children before starting kindergarten. Another booster dose is recommended for adolescents, ideally at 11-12 years of age, and because vaccine protection for tetanus, diphtheria, and pertussis can fade with time, adults should also get a booster dose.

A pertussis booster vaccine, known as Tdap, is now recommended for adolescents and adults; it boosts protection against tetanus, diphtheria, and pertussis. Pre-teens going to the doctor for their regular check-up at age 11 or 12 years should get a dose of Tdap.

Adults who didn?t get Tdap as a pre-teen or teen should get a dose, as should adults who are healthcare workers or who care for infants.

Centers for Disease Control and Prevention (CDC) data for the U.S. indicate that between 2000 and 2005 there were 140 known pertussis-related deaths, 90% of which occurred in infants less than 1 year of age. About half were likely the result of exposure to a household member who had pertussis or an illness that was probably pertussis.

Pertussis is a respiratory infection caused by bacteria that spread easily among persons in close contact, such as members of the same household. The illness starts as with cold-like symptoms of runny nose, sneezing, mild cough, and is at that point indistinguishable from many other upper respiratory illnesses. But a week or two later, the cough worsens, becoming a series of severe, intermittent coughing fits, which make it difficult for the patient to get a breath. Children especially may emit "whoop" noise as they finally catch a breath, which is where the illness gets its nickname of "whooping cough." The bouts of coughing may end in vomiting and often leave the patient exhausted.

This phase of the illness can last several weeks, followed by several more weeks of illness where the cough gradually begins to decrease.

Pertussis is often not recognized until the patient has been ill for many weeks.

Nationally, reported cases of pertussis have been rising over the past 20 years. In 2004, 25,827 were reported, the most in any year since 1959. Almost as many cases were reported in 2005. Experts believe that many cases likely go undetected and unreported, and that some of the increasing trend may be explained by better recognition and reporting of the disease.

Treating patients and those persons in close contact to them with an appropriate antibiotic is important because it helps shorten how long they are contagious, and may help prevent complications, although it doesn?t tend to help lessen the severity of the cough.

 

[Shiloh]

Re: MI: Whooping cough

Source: http://www.connectmidmichigan.com/news/story.aspx?id=354972

Whooping cough cases up significantly in Genesee County
Friday, September 25, 2009 at 12:53 p.m.

In the last month, the Genesee County Health Department (GCHD) identified eight confirmed cases of pertussis, commonly called whooping cough, in Genesee County.

This is a significant increase compared to 2008 when only seven cases were reported during the entire year. Four of the eight cases were among infants too young to be fully immunized against pertussis and two cases were among school-aged children.

The GCHD is informing the community of this recent outbreak and advising all concerned individuals to check their immunization status, as well as their children?s.

Pertussis is a highly communicable, vaccine-preventable disease. The GCHD is reminding health care providers that pertussis is increasing in the community and to consider it in their differential diagnoses. Those diagnosed with pertussis should be treated with an appropriate antibiotic. Persons exposed to a case of pertussis should make sure that they are properly vaccinated against pertussis. In some situations, those in very close contact to a case of pertussis may need treatment to prevent the disease.

People of any age can be infected by pertussis, but young children, especially infants, are at the greatest risk for severe pertussis disease and serious complications. Symptoms begin like a cold and include fever, runny nose and coughing episodes that gradually become more severe. Coughing episodes persist and become frequent even after cold symptoms subside and can last 1 month or longer.

Vaccination against pertussis is the best way to control and prevent the disease. Pertussis vaccine is administered in combination with diphtheria and tetanus vaccine (DTaP) in a five-dose primary series and protects children against whooping cough. The booster dose of the vaccine that protects against pertussis (Tdap) is recommended for adolescents and adults aged 11-64 years.

Pertussis often goes unrecognized and undiagnosed in adolescents and adults because they typically experience a milder course of illness. It is critical that adolescents and adults ensure that they are properly vaccinated against pertussis.

Anyone who has symptoms that he or she thinks might be pertussis should consult a health care provider. For more information see the GCHD website at www.gchd.us.