Central Oregonian

Health Department taking steps to prevent an outbreak of whooping cough

The state of Washington remains in epidemic status, which has Oregon health officials concerned

Jason Chaney

January 07, 2013

Early in 2012, Washington state residents saw an outbreak of pertussis, commonly known as whooping cough, that threatened to spread to residents in Oregon.

Since that time, Crook County health officials have increased efforts to ensure the disease does not gain a foothold locally.

At this time, Washington remains in epidemic status, with more than 100 reported or probable cases of pertussis remaining as of November, according to Washington State Department of Health data. During the epidemic, the illness has spread into the northwestern Oregon.

“Because of the people who live in Vancouver, Wash., and work in Portland and vice versa, the border counties in northwest Oregon started to see an increase in numbers,” said Karen Yeargain, Communicable Disease Coordinator for Crook County.

According to Oregon Public Health Division statistics, Oregon reported 307 cases of pertussis in 2011. For 2012, that amount spiked to 870. Nevertheless, Crook County has not encountered any Pertussis diagnoses in the few years, and only a small amount of cases have emerged in Central Oregon in general.

“Luckily, we haven’t seen a lot of that over here,” Yeargain said.

Pertussis is a bacterial infection spread through coughs, sneezes, or other exposure to respiratory secretions. Yeargain said it can start out like typical head cold, making it hard to detect at first. Later, the symptoms become more obvious.

“Within a week, as you think that that would be tapering off, the cough get worse,” she said. “Generally, it’s two or three weeks before the person says, ‘Wait a minute, this isn’t going away. This is different.’”

Pertussis can be deadly for very young children.

“It creates a lot of mucus and as the lungs are trying to get rid of that, it can actually clog up the airways of an infant or a toddler, because their airways are smaller, and it causes them to stop breathing,” Yeargain explained. “So the cough begins to have that classic ‘whooping’ at the end at is caused by the person really struggling to get air.”

Despite the low occurrence of pertussis during the Washington epidemic, Yeargain said there are reasons to improve prevention efforts.

First of all, as the epidemic continues, Crook County residents remain at risk as people travel to and from the Portland area. In addition, people may no longer be protected from the illness.

“The vaccine we have is DTAP (diphtheria, tetanus, and pertussis) for the little kids and then in recent years, we have had an adult version of that called TDAP (tetanus, diphtheria, and pertussis),” Yeargain said.

The DTAP vaccine was designed to protect children through their most vulnerable years, but it wears off after about 10 years.

“So what we are seeing are more people in their teenage years who their original immunity for their vaccine has been lost and they were coming down with Pertussis, and they were giving it back to the little ones before they could be fully vaccinated,” Yeargain said.

Consequently, Crook County health officials have recently taken a more proactive approach to getting residents who are teens or older vaccinated. Those efforts will be aided by recent grant funding for immunization outreach.

The Center for Disease Control and Prevention (CDC) awarded Oregon a $1.8 million grant to increase adult flu and TDAP vaccinations. Crook County received $26,574 of that money, part of which enabled the Crook County Health Department to hire a new part-time immunization coordinator.

“The real goal of the grant is to establish consistent long-term partnerships within the community,” said Mindy Stomner, R.N., the immunization coordinator hired by the Health Department. She said those partners will include pharmacies, non-healthcare employers, community centers, healthcare institutions, and long-term care facilities.

The County also received some vaccine as part of the grant award.

“It is earmarked for those who have no insurance, so that we can get it into bodies that have no other resources to pay for it,” Stomner said.

As evidenced by an outbreak of meningitis in Crook County last year, local health officials believe the more people they can immunize, the easier they can keep a Pertussis from gaining a foothold in the community.

“It is easier to prevent than it is to treat,” Stomner said, “so we are all about prevention.”

Pertussis is a highly contagious acute bacterial infection of the respiratory tract, attributable to bordetella pertussis. It is transmitted from person-to-person through contact with respiratory secretions (droplet transmission). The disease is most severe in infants and young children, many of whom suffer the intense paroxysmal coughing that usually terminates in an inspiratory “whoop.” Although the disease may be milder in older persons, those who are infected may transmit the disease to other susceptible persons, including unimmunized or incompletely immunized infants.

To receive the TDAP vaccine, contact the Crook County Health Department at 541-447-5165, Clinic Pharmacy at 541-447-4111, or Crook County’s School-based Health Center at 541-447-7064.