SAN JUAN COUNTY DEPARTMENT OF HEALTH

More than 40 cases of whooping cough on Orcas Island

Health Department urges parents to take immediate action
to protect young children

posted 01/18/2008
All Orcas and Lopez residents with a persistent cough are urged to see their health care provider for evaluation, testing and treatment of pertussis (whooping cough).

The County Health Department is continuing to investigate more than 40 cases of pertussis on Orcas Island. After starting among a few childcare facilities, the outbreak has become a community-wide outbreak. When outbreaks move from focused to community-wide the CDC recommends that anyone in the community with cold like symptoms should be evaluated, tested, and treated to avoid further spread of the disease. More than forty cases have been identified on Orcas and at least two cases are being investigated on Lopez Island. For close contacts and suspected cases of any age a course of antibiotics is recommended to prevent disease and limit contagiousness.

Pertussis is most contagious during the first week when symptoms are mild, similar to a bad cold with slight fever, runny nose and a cough. The irritating cough persists and gradually develops into a series of repeated and violent coughs (many occur without an opportunity to inhale), and then may be followed by a high-pitched whoop as they inhale and/or vomiting in children. Adults often have just a moderate to severe cough. Anyone with these symptoms is urged to avoid contact with children less than one year of age, pregnant women, the immune suppressed and those with advanced lung disease until examined by a health care provider to prevent spreading the disease. The contagious period lasts until 3 weeks after the onset of the fits of coughing or until five days of treatment with an appropriate antibiotic have been completed. The illness may last for two months or longer.

Pertussis is potentially fatal in young children less than one year old, one in 200 cases in this age group die from the infection. Vaccination is possible as early as 6 weeks of age. Because pertussis is among the most lethal diseases of unimmunized infants and young children, parents should keep young infants and unimmunized children away from individuals with even mild cough and upper respiratory illness and start the series of immunizations with the DTaP vaccine. Immunization of children less than seven years of age is critical for control of pertussis.

It is known that older children and adults with mild persistent cough illness (unrecognized as pertussis) are another major source of transmission. There is now a vaccine available for those ten years of age and older, called Tdap. It provides a booster dose of pertussis vaccine along with tetanus and diphtheria vaccines. This new vaccine is recommended for adolescents getting their routine booster dose and for adults, especially those who have contact with the high risk groups mentioned above. Vaccine is available through the San Juan County Health Department and through local physicians.

Contact the Health Department at 378-4474 for information regarding pertussis disease.

Health Department urges parents to take
immediate action to protect young children

posted 01/09/2008
Parents are urged to get children fully immunized against pertussis (whooping cough). This disease is potentially fatal in young children less than one year old. Vaccination is possible as early as 6 weeks of age.

Currently the Health Department is investigating several confirmed cases of pertussis on Orcas Island. Most people who have been in contact with these cases have been notified and referred to their family physicians for preventive treatment. For close contacts and suspected cases of any age a course of antibiotics is recommended to prevent disease or limit contagiousness.

Pertussis is most contagious during the first week when symptoms are mild, similar to a bad cold. The irritating cough persists and gradually develops into a series of repeated and violent coughs (many occur without an opportunity to inhale), and then may be followed by a high-pitched whoop as they inhale and/or vomiting. Anyone with these symptoms is urged to avoid contact with small children until examined by a health care provider to prevent spreading the disease. The contagious period lasts until 3 weeks after the onset of the fits of coughing or until 5 days of treatment with an appropriate antibiotic have been completed. The illness may last for 2 months or longer.

Pertussis is among the most lethal diseases of unimmunized infants and young children. Parents should keep young infants and unimmunized children away from individuals with even mild cough and upper respiratory illness and start the series of immunizations with the DTaP vaccine. Immunization of children less than seven years of age is critical for control of pertussis.

It is known that older children and adults with mild persistent cough illness (unrecognized as pertussis) are another major source of transmission. There is now a vaccine available for those seven years of age and older. Called Tdap, it provides a booster dose of pertussis vaccine along with tetanus and diphtheria vaccines. This new vaccine is recommended for adolescents getting their routine booster dose. Vaccine is available through the San Juan County Health Department and through local physicians.

Contact the Health Department at 378-4474 for information regarding pertussis disease.

Whooping cough cases
on the rise

EDITOR's NOTE: this was first posted in 2000)

posted 10/07/2000
Several cases of pertussis (whooping cough) have been confirmed in San Juan County.

The following is a letter from Dr. Frank James, San Juan county health officer:

Pertussis (whooping cough) has been circulating in San Juan County for the past few weeks. There have been several laboratory confirmed cases and many additional clinically likely cases. These cases have occurred largely in young adolescents who attend middle and high school. Deaths from pertussis are rare with 80 percent occurring in those under one year of age and 70 percent occurring under six months of age. While pertussis can be prevented through vaccination, immunity wanes over time, with many children becoming susceptible by 10 to 15 years of age.

Symptoms of pertussis include low-grade fever, runny nose, conjunctivitis and malaise which may last one to two weeks. The initial dry cough is eventually supplanted by paroxsymal (whooping) cough. The latter is much less likely in adults than in young children. Coughing lasts for weeks, occasionally months.

Infection is from respiratory secretions and air born droplets. Covering one's mouth when coughing is an effective means of decreasing transmission of the disease. Disposable tissues should be available and in use in the school setting.

Pertussis facts:

Symptoms:

• initial dry cough eventually supplanted by paroxysmal cough
• low-grade fever
• runny nose
• conjunctivitis
• malaise
• Coughing last for weeks

Incubation period

Incubation period: six to 20 days.

Most contagious during early stage before cough becomes paroxysmal.

Not contagious after five days of anti-biotic treatment.

Tests

DFA and culture tests for pertussis are available through the public health department. Call 360.378.4474 for more information.

The incubation period is six to 20 days with the highest communicability in the early stage before the cough becomes paroxysmal. Communicability eventuarlly becomes negligible after about three weeks. When treated with antibiotics the period of infectiousness is five days after starting treatment.

Individuals who have been significantly exposed should receive prophylactic antibiotic treatment. This would include students who have intimate contact with classmates (best friends, share car pool to school, spend a lot of time together outside of school). Simply riding on the bus with or being in the same classroom with a diagnosed person would generally not be considered a reason to take preventive antibiotics.

Students who develop symptoms of early pertussis and who are classmoates of, or who ride on the bus to school with a clinically diagnosed case or a lab confirmed case, should be referred for medical evaluation with their primary care provider. These children should at a minimum be given a "DFA" and a culture test for pertussis. Some of these children and their parents will choose to receive preventive antibiotics as well as have tests performed. A negative DFA test is not adequate evaluation by itself (it is the quickest way to get a positive result, but sometimes can be negative when the culture is actually positive, as has been the case with several local cases). DFA and culture should be done on all suspected cases.

If you have questions about the diagnosis, treatment or management of pertussis do not hesitate to contact the health department at 360.378.4474.

PREVIOUS STORIES ON WHOOPING COUGH

Whooping cough in county

posted 06/29/05
PRESS RELEASE: The county Health Department is investigating one confirmed case of pertussis (whooping cough) and another related case is probable. Many contacts have been notified and referred to their family physicians for preventive treatment. Pertussis has been identified in neighboring counties so exposure is likely as people travel.

Pertussis is most contagious during the first week when symptoms are mild like a bad cold. The irritating cough persists and gradually develops into a series of repeated and violent coughs (many occur without an opportunity to inhale), and then may be followed by a high-pitched inspiratory whoop and/or vomiting. The contagious period lasts until three weeks after the onset of the fits of coughing. The illness may last for one to two months or longer.

Pertussis is among the most lethal diseases of unimmunized infants and young children. Parents should keep young infants and unimmunized children away from individuals with even mild cough and upper respiratory illness and start the immunization series. Immunization of susceptible children less than seven years of age is critical for control of pertussis. Vaccine is available through the San Juan County Health Department and through local physicians.

It is known that older children and adults with mild persistent cough illness (unrecognized as pertussis) are a major source of transmission. There is no vaccine available yet for those seven years of age and older. However, for close contacts and suspected cases of any age a course of antibiotics is recommended to prevent disease or limit contagiousness.

Contact the Health Department at 378-4474 or your physician for information regarding pertussis disease or DTaP vaccinations.

Third pertussis outbreak in county

posted 08/27/03
"We have now had three separate outbreaks - clusters - of pertussis in San Juan County," County Public Health Director Dr. Frank James told the BOCC August 26, 2003. The first was on Orcas Island with two cases. The second case involved three cases on San Juan Island. The third case involves 15 confirmed cases with 130 additional people to be treated as a precaution.

"For adults pertussis is not a big deal," said James. "For kids in school it is not a big deal. But one in 100 children under two years of age who contract the disease die. Infants under six months of age drown in their own secretions. "Even In the best medical care, there is sometimes nothing we can do," said James. "Our goal is to prevent very young children from getting it."

The symptoms and recommendations to prevent the disease are posted in the article at the bottom of this page. For more information call the county health dept at 360.378.4474.

Whooping cough in county

posted 07/22/03
One case of pertussis (whooping cough) has been diagnosed through preliminary laboratory tests and two other related cases are suspected. The county Health Department is conducting a separate investigation around three suspected cases unrelated to the diagnosed case.

Many contacts have been notified and referred for preventive treatment. Pertussis has been identified in neighboring counties, so exposure is likely with so many people traveling this summer.

Pertussis is most contagious during the first week when symptoms are mild like a bad cold. The irritating cough persists and gradually develops into a series of repeated and violent coughs (many occur without an opportunity to inhale), and then may be followed by a high-pitched inspiratory whoop and/or vomiting. The contagious period lasts until three weeks after the onset of the fits of coughing. The illness may last for one or two months or longer.

Pertussis is among the most lethal diseases of unimmunized infants and young children. Parents should keep young infants and unimmunized children away from individuals with even mild cough and upper respiratory illness and start the immunization series. Immunization of susceptible children less than seven years of age is critical for control of pertussis. Vaccine is available through the San Juan County Health Department and through local physicians.

It is known that older children and adults with mild persistent cough illness that may not be recognized as pertussis can be a major source of transmission. There is no vaccine for those seven years of age and older. However, for close contacts and suspected cases a course of antibiotics is recommended to prevent disease or limit contagiousness.

Contact the Health Department at 378-4474 or your physician for information regarding pertussis disease or DTaP immunizations.

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