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Health officials recommend whooping cough vaccinations

By Megan Workman

CHARLESTON, W.Va. -- Although West Virginia hasn't experienced an outbreak of whooping cough, state health officials said residents should be concerned that other parts of the country have declared it an epidemic.

So far in 2012, there have been 60 investigated cases of whooping cough, also known as pertussis, in the state, according to the Kanawha-Charleston Health Department. Last year, 102 pertussis cases were reported.

Pertussis is a contagious disease that is spread through coughing and sneezing while in close contact with other people. Among vaccine-preventable diseases, pertussis is one of the most commonly occurring ones in the United States, according to the U.S. Centers for Disease Control and Prevention.

In April, the Washington State Department of Health declared a pertussis epidemic. More than 3,000 confirmed cases were reported there from Jan. 1 to June 30, according to the CDC. In that same time period in 2011, only 297 pertussis cases were reported in that state.

West Virginia has typically seen a low number of reported pertussis cases in the past: In 2010, there were 178 reported cases; 43 cases in 2009; and 11 cases in 2008.

Only three pertussis cases have been reported in Kanawha County this year, said Dr. Rahul Gupta, executive director of the Kanawha-Charleston Health Department.

"Just because we have low numbers, our county is one disease outbreak away. You can have one good outbreak and have several hundred pertussis cases in weeks," Gupta said. "Having low numbers is a good thing, but we don't want to put our red flag down. If it can happen in Washington, it can happen in West Virginia."

Gupta said one reason for the rise in pertussis cases in the United States is simply that the disease is being detected more.

There are many more pertussis cases that occur, but they aren't always reported, he said. The disease starts like the common cold, with a runny nose or congestion, sneezing and a mild cough or fever, according to the CDC. After a week or two, a severe cough -- often followed by violent, rapid coughing fits -- begins. The sick person is forced to inhale, creating a loud "whooping" sound.

The disease is treated with antibiotics, but some people are better before they even realize they have the infection, Gupta said.

"We thought before, if you got a shot as a child then you'd never need another shot again,

Gupta said. "We are finding more detection than we used to before."

Certain areas - such as Washington state -- become more vulnerable to the disease when people do not keep their shots up to date, Gupta said. A low level of community immunity makes pertussis spread easily, which turns into an outbreak, he said.

"If we have lower vaccination rates -- which we do in West Virginia -- it's a recipe for a good outbreak," said Janet Briscoe, director of epidemiology for the KCHD. "That's why we're pushing this idea for getting as many people immunized."

State epidemiologist Loretta Haddy said the obvious method for avoiding the vaccine-preventable disease is vaccination. Haddy said the pertussis outbreaks throughout the nation are a warning for West Virginians who have yet to get a vaccination.

"It's a warning. It's an educational message. If you haven't received a dose of TDaP, you should, because it's preventable by the vaccine," Haddy said. "I'm not saying it's 100 percent, because it's not. No vaccine gives you 100 percent protection."

Briscoe said it's important for adults to get a TdaP vaccination, which immunizes against tetanus, diphtheria and pertussis, to protect children and infants, "who are the most vulnerable population," she said.

The highest pertussis rates in West Virginia are among children ages 5 to 14 years old, Gupta said.

Parents and grandparents should get the vaccination, he said, since they can easily pass the infection on to children.

About 80 percent of pertussis cases are spread through household contact, Briscoe said.

"I think most infants that acquire pertussis do so from contact of parents and grandparents who don't realize they have the disease. Their symptoms do not manifest like they do in children," Gupta said. "When adults get pertussis it's usually like a nagging cough that stays for a few weeks and goes away. But the newborns aren't born with inherited immunity to pertussis. If you're a parent or grandparent, getting the shot protects that child before they can protect themselves."

More than half of infants younger than 1 year old who get pertussis are hospitalized, the CDC states. Of the 27 U.S. deaths as a result of pertussis in 2010, 25 of them were in children younger than 1 year old.

"Why does everybody need to get vaccinated? It's about 85 percent effective, but the more people who get it, the better off the community is. The more people who have immunity to the disease, the fewer people who will have the disease," Gupta said.

•••

Vaccine recommendations from the CDC and the Kanawha-Charleston Health Department:

| For Infants and Children: Vaccine is called DTaP. Protects children against three diseases: diphtheria, tetanus and pertussis. Children need five DTaP shots. The first three shots are given at 2, 4, and 6 months of age. The fourth shot is given at 15 through 18 months, and a fifth shot is given when a child enters school, at 4 through 6 years of age. If a 7- to 10-year-old is not up-to-date with DTaP vaccines, a dose of the booster Tdap should be given before the 11- to 12-year-old checkup.

| For Preteens and Teens: Vaccine protection for pertussis, tetanus, and diphtheria can decrease with time. Preteens going to the doctor for their regular checkup at age 11 or 12 should get a booster vaccine of TDaP.

In West Virginia, students entering seventh grade will have to show proof of a TDaP booster and a dose of meningococcal vaccine. Twelfth-graders will have to show proof of a single dose of TDaP vaccine and at least one dose of meningococcal vaccine given after his or her 16th birthday.

| For Adults: Adults 19 and older who didn't get TDaP as a preteen or teen should get one dose of TDaP.

The easiest thing for adults to do is to get TDaP instead of their next regular tetanus booster --- the Td shot that is recommended for adults every 10 years.

To learn more about pertussis in West Virginia, visit www.dhhr.wv.gov/oeps/disease/IBD--VPD/VPD/Pages/Pertussis.aspx or call 304-552-5358.

Reach Megan Workman at megan.workman@wvgazette.com or 304-348-5113.


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