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Whooping cough hits the Bitterroot

By Michael Howell

The number of cases of pertussis, commonly called whooping cough, is growing at an alarming rate in the Bitterroot, according to Public Health Nurse Judy Griffin. As of Monday, the number of confirmed cases totaled 33. Four of the 33 are adults, the rest are students at Corvallis and Victor schools and a few, more recently, at Ravalli Head Start.

“We continue to get positives practically every day,” said Griffin.

Pertussis is a highly contagious bacterial disease caused by Bordetella pertussis. In some countries, the disease is called ‘the cough of 100 days’.

Symptoms are initially mild, and then develop into severe coughing fits, which produce the namesake high-pitched “whoop” sound in infected babies and children when they inhale air after coughing. The coughing stage lasts for approximately six weeks before subsiding.

Prevention via vaccination is of primary importance, according to Griffin. Antibiotics, however, do decrease the duration of infectiousness and are thus recommended. It is estimated that the disease currently affects 48.5 million people yearly, resulting in nearly 295,000 deaths.

On Monday, April 23, the County Commissioners agreed to pull un-immunized children from the schools in Corvallis and Victor. Griffin said it was the first time ever for such an action in Ravalli County. It is only the second time in the state. Last year Bozeman did the same thing during a pertussis outbreak that infected 40 people.

“It’s a serious disease,” said Griffin, “Babies are especially vulnerable.” She said one Bitterroot Valley child was hospitalized due to the illness but has since been released and is recovering. Griffin cautioned that the disease could be deadly and lead to secondary infections such as pneumonia.

The workload on health officials in dealing with the outbreak is substantial. It involves complete disease surveillance of every infected person and treatment of all those who came into contact with them.

Contacts are given a five-day treatment of Zithromax, an antibiotic. Those who show symptoms must stay at home during treatment, others, who show no symptoms may go to school or work.

Griffin said she is encouraging immunization.

“What we are trying to do is increase the herd immunity,” said Griffin. She said that if enough people in a community are immunized it helps protect those who aren’t. Griffin said the best place to get information about pertussis is on the internet at the website of the Center for Communicable Disease.

The Montana Department of Public Health and Human Services (DPHHS) issued a release on Monday that outbreaks of pertussis, also known as whooping cough, are being reported in several areas of Montana and is urging vaccines for all children and adults to help prevent the disease.
Since January 2012, nearly 90 cases of pertussis have been reported statewide, compared to approximately 50 cases for the same period last year. In addition to Ravalli County, recent cases have been reported in Broadwater, Gallatin, Lewis and Clark, and Stillwater counties. Local and state public health officials are concerned that the number of reported cases will continue to increase unless people take action to protect themselves and others. According to DPHHS health officials, pertussis is a highly contagious respiratory illness spread by coughing and sneezing, but one that may be prevented by getting vaccinated. Although it initially resembles an ordinary cold, pertussis can turn more serious, particularly in infants. Over half of infants diagnosed will require hospitalization.
Washington State has reported a large increase in reported pertussis, with nearly 800 cases reported over the last four months. Montana health officials do not want what is occurring in Washington State to happen here.
“Most cases of pertussis are preventable,” said DPHHS Director Anna Whiting Sorrell. “All parents and caregivers of children need to make sure their children are up to date on this and other vaccines. Anyone who cares for children should also be up to date on their vaccinations to prevent spreading pertussis.”
People who are vaccinated are unlikely to become ill after an exposure or spread the illness to others.
Local health jurisdictions with recent cases are working hard to control or stop the spread of the disease. Close environments such as schools and daycares are ideal for easily and quickly spreading pertussis and present challenges to health officials.

“We encourage parents to not send children who are ill to schools and daycares because pertussis spreads quickly in these settings,” said Karl Milhon, manager of the DPHHS Communicable Disease Program.
Pertussis vaccination begins at age two months, but young infants are not adequately protected until they have received a series of vaccinations. Because protection from the vaccine can fade over time, a booster is recommended for pre-kindergarten age, pre-teens, teens, and adults.
More information is available from local health providers and public health departments, or go to www.dphhs.mt.gov.

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