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Thursday, November 13, 2014

Kentucky has a statewide outbreak of whooping cough, perhaps because the child-immunization rate is declining

Kentucky is having a statewide outbreak of pertussis, also called whooping cough, Jennifer Wohlleb reports for the Kentucky School Advocate, the magazine of the Kentucky School Boards Association. This comes at a time when the immunization rate among Kentucky school children is declining.

At least 230 cases of whooping cough have been diagnosed so far this year, and there were more than 300 confirmed cases last year, Wohlleb reports.

“And those are just reported cases, and most of those are in children,” Kraig Humbaugh, director of the state Division of Epidemiology and Health Planning, told Wohlleb. “And young children are the ones most likely to have the severe consequences, including unfortunately, death."

Another childhood disease, measles, remains in check. Humbaugh told Wohlleb, "We haven’t seen a case of it this year, but almost all of our surrounding states have and there is currently a measles outbreak … with cases that have been imported from other countries.”

That's important to remember, Humbaugh said. “We live a global economy and every day, people can come here from other countries,” where illnesses like measles and polio are still an issue, she said. “Vaccines and immunizations are really, really important, but some people get really complacent because we don’t see them (these diseases) as much anymore, but they’re still a threat.”

During the 2013-14 school year, 81.7 percent of Kentucky sixth-graders received theTdap booster shot, which protect against tetanus, diphtheria and pertussis. That is below the national average of 84.6 percent. The state’s rate of childhood series immunizations has fallen to 72.7 percent in 2013 for 80.6 percent in 2011, according to the National Immunization Survey, Wohlleb reports.

Schools in Scott County and Hart County both had an outbreak last year and discovered that many of those getting whooping cough were at the age where they needed a booster or right before the age where they needed a booster, Wohlleb reports.

Local health departments help districts communicate with parents, and can provide them with crucial information about the course of an illness.

“Once (a student) is considered to be infectious, it would be recommended that they stay out of school until they have received five days of the appropriate antibiotic treatment, or 21 days from the onset of cough,” Sharon Ray of the Barren River District Health Department told Wohlleb. “So you can see, if we don’t find out about it until you’re three weeks into a cough illness, you’ve already been there your whole infectious period, so we can’t shorten your infection time; where if we know early, we may not keep that student from getting sick, but we may shorten their infectious time to others.”

Kentucky allows parents to exempt their children from vaccinations for medical or religious reasons; it does not allow philosophical exemptions. Humbaugh told Wohlleb that vaccines are "one of the greatest medical success stories of the 20th century," and said "fear and misinformation about vaccinations may be contributing to lower rates of immunizations in areas of the country. "

“I think one thing people fear are side effects of vaccinations,” Humbaugh, who is also a pediatrician, told Wohlleb. “I think the literature shows that certainly, and the 20th century will bear that out, the benefit of being vaccinated for childhood diseases is greater than the small risks associated with vaccinations. To me, vaccinations are like any other type of medication that you give, everything has risks; taking Tylenol has risks. But the risks are very low. These are in general safe, proven effective vaccines, all approved by the U.S. Food and Drug Administration.

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