Tooele Transcript Bulletin – News in Tooele, Utah
image Tooele County Health Department immunization coordinator Louise Ekenstam gets ready to give county worker Andy Tanner the DTaP shot, which protects against tetanus, diphtheria and pertussis Thursday morning at the health department building. Health officials are worried that the county’s low number of reported whooping cough cases means that the disease is going untreated.

November 15, 2012
Health officials urge vaccination as whooping cough cases rise

Whooping cough cases have been on the rise across the state and nation in recent years, but when it comes to Tooele County, only a small number of people have been officially diagnosed. That makes local health officials worried that many people with whooping cough are going untreated. Because of this, they’re urging residents to get vaccinated — especially now that whooping cough season is underway.

So far this year, Tooele County has only had three cases of whooping cough — the common name for the disease known clinically as pertussis — according to the Utah Department of Health. Statewide, however, there have been 1,108 cases reported as of Nov. 10, according to UDOH epidemiologist Valerie Vernon. In Tooele County, the rate of cases per population is estimated to be 5.8 cases per every 100,000 people, while statewide the rate is 45.1 cases per every 100,000 people.

Vernon said this difference can mostly be attributed to less people in Tooele County being officially diagnosed with the disease. This could be because less people choose to go to the doctor or because there aren’t as many clinics in Tooele County as there are in more populous counties.

“What we know about pertussis is that when adults get it, they just believe they have a really awful cold that won’t go away,” said Louise Ekenstam, immunization coordinator for the health department. “They can be sick with a cough for a good month, but they don’t always seek medical care. For every case we do have, a lot more go undiagnosed because individuals won’t seek medical care.”

Ekenstam said this is a concerning trend because these people are most likely spreading the disease.

“During the holidays people are out shopping and eating, and if someone has whooping cough, they could be giving it to any child or adult they are around,” she said.

In Utah, pertussis activity peaked during the 1920s with an annual average of over 3,900 cases for that decade. The introduction of a vaccine during the 1940s resulted in a dramatic decrease in cases, leading to a 90 percent reduction in total case counts by the 1950s, according to the UDOH. However, the number of cases reported statewide has been increasing since 2006.

“We’ve seen quite a bit of pertussis activity statewide,” Vernon said. “The golden question is why is this happening? But there’s no one answer to explain why. This is a multi-faceted problem.”

One problem, discovered recently by the Centers for Disease Control and Prevention, she said, is that the vaccines aren’t lasting for 10 years, as originally thought.

“Children who are receiving their required vaccine for pertussis before entering seventh grade are coming down with pertussis four to five years later,” she said. “Now the CDC is researching this to see if we need to change the vaccine recommendations.”

Vernon said another reason why pertussis could be more common statewide is that every four to six years there is an increase in the amount of cases because it’s the natural, cyclical nature of the disease.

“People get it, it dies down and then it rears up again,” she said. “We’re in that window right now where people are getting it.”

Ekenstam said the health department has given several pertussis vaccinations over the last couple of years, but still hasn’t vaccinated even a third of the county’s population.

“We’re just barely moving into pertussis season, but I do believe the first case I had this year was earlier than the first case I had last year,” Ekenstam said. “As we start spending more time out shopping or around people for the holidays, that’s when we start seeing an increase in numbers.”

Pertussis is an infection that starts off as a generalized cough. Dawn Powell, a pediatric nurse practitioner at Stansbury Springs Health Center, said the disease becomes concerning when children start fits of coughing that impair their ability to breathe. Children most at risk are those who haven’t received their full vaccinations yet. Infants are most vulnerable because they don’t receive their first pertussis vaccine until they’re two months old. It is recommended that children receive five doses of pertussis vaccination through the DTaP shot, which also protects against diphtheria and tetanus, by the time they enter first grade. After that, they receive a booster dose of the same vaccines, called a Tdap shot, before entering seventh grade. The highest rate of pertussis is seen in children under a year of age and those 5 to 14 years old.

Powell said symptoms of pertussis are different in adults. Adults have a hacking cough that doesn’t seem to be much different from a common cold, but the cough will last for months. If a child gets pertussis, they have a good chance of being hospitalized.

“Early on, you’ll see just common cold symptoms like sneezing, a running nose and a mild cough,” Powell said. “After a couple of weeks, the cold symptoms go away and the cough gets worse. You’ll have coughing attacks, choking, difficulty breathing and make a whooping sound.”

Ekenstam said it’s important for people to get vaccinated because they’ll be protecting more than just themselves.

“The one thing that I want to stress with regards to vaccinations is that you don’t just vaccinate to protect yourself,” Ekenstam said. “You vaccinate to protect those you’re around. If you are vaccinated, then you can’t pass it on to children. If you’re not, you can pass it on to someone you don’t even know.”

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