http://www.mailtribune.com/archive/2003/0523/local/stories/03local.htm

May 23, 2003

Whooping cough spreads; 4 infants now ‘gravely ill’

By BILL KETTLER

Mail Tribune

Jackson County’s outbreak of whooping cough has spread beyond Medford, and public health officials have identified at least 34 people who may have the disease.

Children and adults whose symptoms strongly suggest pertussis have been contacted in Trail, Eagle Point, Central Point, White City, Jacksonville and Phoenix, said Hank Collins, Jackson County’s director of health and human services.

"This is a disease that people should take seriously," Collins said Thursday.

A week ago, there were three confirmed cases and seven suspect cases, all in Medford.

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For the 10 years from 1993 to 2002, Jackson County reported just 11 cases, according to statistics compiled by the Oregon Department of Human Services.

Pertussis is a bacterial infection that was common among infants before vaccines were developed. Its common name was derived from the gasping cough that is its chief symptom.

Pertussis can strike anyone, but it hits infants hardest, and it can be fatal if pneumonia develops.

In adults it often appears as a cold, followed by a deep wracking cough that lasts for weeks. Seventy percent of all fatalities occur in infants under the age of 6 months.

State testing laboratories have confirmed just four pertussis cases in the county so far, but Collins said there are 13 presumptive cases and 17 suspect cases. A presumptive case is one in which a person has symptoms of pertussis and had contact with someone who already has tested positive for the disease. A suspect case is one in which a person has symptoms of pertussis.

Collins said pertussis cases in Jackson County’s outbreak range in age from several months to 42 years. Of the 34 confirmed and likely cases, seven are infants, including four whom Collins described as "gravely ill." Twenty cases are between the ages of 1 and 21; seven are adults.

Collins said the county seems to have a small reservoir of older children and adults who have pertussis and have been spreading it to infants and smaller children.

"It doesn’t make (older people) gravely ill," he said, "but they’re passing it on to babies."

Infants are typically immunized at 2, 4, 6 and 15 months, and again before entering school. Collins said parents need to limit small children’s exposure to people in general, and especially to people who are sick.

"It’s amazing how many people some infants have had contact with," he said. "We’ve seen babies that are 2 months old that have been baby-sat by 16 different people."

Public health workers have been tracing each infected person’s contacts with others and alerting each person about the disease.

Outbreaks of pertussis occur periodically across Oregon, said Dr. Katrina Hedberg, a state epidemiologist in Salem. Deschutes and Marion counties, for example, had outbreaks in 2002. This year the disease has surfaced in Lane County and Klamath County, where an 11-week-old baby boy became Oregon’s first pertussis fatality in three years.

Collins said the outbreak is almost certain to spread to Ashland, where many school-age children have not been immunized against childhood diseases such as pertussis.

"I dare say it can’t stay out of Ashland if it continues to grow," he said.

Oregon law exempts parents from immunizing their children if their religious beliefs do not condone the practice. Ashland schools have one of the highest rates of religious exemptions. In 2001, 430 Ashland students, or 12.3 percent of the district, claimed the exemptions, compared to a state average of 1.67 percent.

Reach reporter Bill Kettler at 776-4492, or e-mail bkettler@mailtribune.com

On the Web: www.ohd.hr.state.or.us/acd/pertussis/

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