Story last updated at 3:08 p.m. Thursday, October 10, 2002

Whooping cough hits Homer
by Carey James
Staff Writer

Two cases of whooping cough were confirmed last week, and at least 15 more people are being tested for the illness, which is particularly dangerous to children younger than 3.

The Alaska Section of Epidemiology reported Friday that one of the two youths who tested positive for the cough, known formally as pertussis, went to high school in the Homer area. The other student attended a Homer charter school.

While awareness has certainly been heightened in the last week, it may still take as long as several months to completely stamp out the whooping cough outbreak.

"It can really take a long time (for an outbreak of pertussis to be controlled). It can go on for weeks and even months," said Dr. Beth Funk, a medical epidemiologist with the Alaska Division of Public Health, adding that people can be infected with the cough and not get sick for 21 days. "We'll be optimistic, but right now we don't know how long it will take."

While older children and adults can catch pertussis, they typically only suffer symptoms similar to a common cold. Younger children, particularly under 3, can then catch the bug from their older siblings or parents and become seriously ill.

Pertussis is an illness that got its nickname, whooping cough, from the sound patients sometimes make during long coughing spells when breathing becomes difficult.

Symptoms start off much like a cold, but in a period of one or two weeks, an irritating cough develops. The cough, which can last several months, may become violent. Some patients have difficulty breathing or vomit during coughing spells. Some develop bronchitis or pneumonia as a side effect of the illness. Infants 6 months old or younger have the highest mortality rate from pertussis, about 0.5 percent. These infants constitute 70 percent of deaths. About 80 percent of deaths are among children under 1 year.

Funk said one of the biggest problems in the fight to contain pertussis is public perception that the vaccine is dangerous. Part of the reason for that perception is that the old vaccine had a relatively high risk of negative reactions. Around half of those vaccinated using the old vaccine had redness, swelling and pain at the injection site. Less than 20 percent suffered fever, and one in 1,750 people suffered a high fever, seizures and other serious symptoms.

That vaccine was retired in 1997 in Alaska and replaced with a new vaccine that contains only portions of the pertussis cell, and reactions have dropped dramatically. According to the Department of Epidemiology, fever results in 3 to 5 percent of patients with the new vaccine, and high fever, seizures and other more serious side effects are rarely reported.

"There is still a perception that the pertussis vaccine is dangerous," Funk said. "In reality, getting the disease is much more dangerous."

Funk said by the time Alaska children come to school, nearly 99 percent are vaccinated. Children attending public school must show proof of vaccination to pertussis, as well as many other illnesses, to attend. Exemptions are available for medical or religious reasons, however.

Statistics are less readily available for how many younger children are current on vaccinations. Funk said by 24 months, around 80 percent of children are appropriately vaccinated.

For those who become infected, Funk said, the department recommends they stay home until they have taken a five-day series of antibiotics. While the antibiotics will not have much impact on the cough, they do decrease the ability of the ailing person to spread the disease on to others.

Antibiotics are effective, however, in slowing the disease in its early stages, before the cough has developed significantly. After the onset of the cough, treatment is mostly supportive, said Funk, including cough suppressants and intravenous fluids, if necessary.

Funk said as cases of pertussis are confirmed, health care workers are looking for anyone who might have been exposed to the infected person, and reviewing their vaccination records. Those who were likely to have been exposed may need to take antibiotics.

Since pertussis spreads through water droplets, not through the air, like chicken pox, the chances for infection are only likely in a close setting, such as with friends or family members.

Funk said anyone who has not been vaccinated, especially those with small children in the house, is advised to do so by contacting the Homer Public Health clinic at 235-8857. The vaccination is given in three doses, at least a month apart, but even the partial vaccination is better than none, Funk said.

"If we don't get our kids vaccinated, the number of cases of pertussis will rise," she said. "We have an excellent vaccine, and it's the best way to protect our children from the potentially deadly illness."

For more information on pertussis, visit www.epi.hss.state.ak.us/pubs/pin_talk/pertussis.avi.

Carey James can be reached at cjames@homernews.com.

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