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Colorado’s increase in whooping-cough cases has babies, moms reeling

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A nearly fivefold jump in Colorado whooping-cough cases is prompting a new round of warnings from families and doctors, who urge the public to get boosters and vaccine-resisters to change heart.

Through early August, Colorado had 735 cases of the life-threatening cough — also called pertussis — compared with an average of 160 at the same point in recent years.

The sharp rise, reflected nationally, is hitting Colorado infants the hardest. Count Valerie Castillo among the moms now shouting for vaccine renewals, after her then-3-week-old son, Jeremiah, stopped breathing and nearly died from the preventable disease.

Two weeks ago, Castillo was nursing Jeremiah through what doctors had told her was a routine cold, holding him on her chest as he hacked and hacked. At 3 a.m., she felt his breath stop, and when she flipped him over, he was a darkening blue.

Jeremiah lost all breath twice more in an ambulance from North Suburban Medical Center to Rocky Mountain Hospital for Children at Presbyterian/St. Luke’s. He was in the intensive-care unit for 13 days — on ventilation, tubed for feeding — from a cough that came with both a whoop and a parting scream.

Only a couple of days ago, when he was finally safe, did the doctors tell Castillo how scared they were for her son’s life.

“I didn’t get to hold him for so long — that was the worst part,” said Castillo, 24, who hopes to be home with the baby this weekend.

Nationwide, pertussis cases hit 22,000 this month, more than twice as many as the same period the year before. Public health officials say the infection tends to spike every three to five years, but they do not have full explanations for this year’s sudden increase.

Colorado’s rate of 10.5 cases per 100,000 people in 2012 is higher than the national average, but not as bad as states with severe outbreaks such as Washington, Wisconsin and Minnesota.

Immunity experts cite a few key factors:

• Current pertussis vaccines do not appear to last as long as an earlier generation of shots. Families who thought they were done with pertussis shots by kindergarten need to consult with doctors about getting an adolescent or adult renewal. Researchers are studying whether those shots also wear out and may require additional boosts during adulthood.

• Infants like Jeremiah can’t get their first shot until 8 weeks, making babies particularly vulnerable. Doctors now urge pregnant women to get shots, which can protect them and pass on some immunity to their babies after birth. They also want other family members and caregivers to make sure they are up to date on shots, for the “herd immunity” effect.

• Better diagnosis means more whooping cough cases are identified than in previous years, and an increase in travel puts more people in contact with disease.

• Vaccine-refusal rates are a concern, in part because Colorado law makes it easy for students to attend school after signing a “personal” exemption to shots. Some states limit exemptions to medical and religious reasons.

Although a national news report claimed Colorado had the second highest refusal rate in the nation last year, at 7 percent of students, state public health officials said they recently got better news.

A CDC report said Colorado’s refusal rate was 5.6 percent, fourth highest in the nation but moving down, said Dr. Rachel Herlihy, immunization section director for state health.

State officials worry the spike in cases could worsen in fall and early winter, the more traditional period for increases in respiratory illness.

At Presbyterian/St. Luke’s, Castillo got a visit from Dr. Lisa Farkouh, whose infant daughter had a similarly severe whooping cough case in 2010.

“Look what happened to Valerie. Look what happened to me,” Farkouh said. “Don’t take that risk with your own family, and don’t put that risk on any other families.”

Michael Booth

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Numbers

735

Cases of whooping cough, or pertussis, in Colorado through early August

160

Average number of cases at a similar point in the year

10.5

Cases per 100,000 in Colorado this year, higher than the national average

5.6%

Colorado’s “refusal rate” for infant vaccines

Whooping cough

Prevention: Check that family members — with recommendations now including pregnant women — have updated vaccinations that include those for whooping cough/pertussis. The updated shot is usually called Tdap, or DTaP, which covers tetanus, diphtheria and pertussis.

Symptoms: Easily spread through the air, pertussis begins with cold-like symptoms such as sneezing, runny nose, mild cough and low-grade fever. After a week or two, the cough becomes more severe, with long fits, ending in a high-pitched “whoop.” Coughing is worse at night and may last months. For infants, the cough is not as severe, but they will stop breathing for short periods or gasp. Adults may not know they have pertussis, but they can still spread it.

Diagnosis: There is a positive test for pertussis, done with a nasal swab.

Sources: State and federal health officials

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Comments
  • comment avatar Kris September 2, 2012

    What will it take for parents and grandparents to demand that unvaccinated children not be allowed to sit in the same classroom with the others?

    • comment avatar Jema September 4, 2012

      How would an unvaccinated child be a threat to a vaccinated child? Not many under 8 wks old in the classroom . . .

  • comment avatar Jen September 2, 2012

    Medical exemptions only. No exceptions. The vax refusers have the luxury of the herd to make their choice ok, but it is now at the consequence of everyone else. This is not ok- for my child or yours.

  • comment avatar Larry September 2, 2012

    It is high time to remove the personal and the “religious” exemptions. We are talking about peoples lives here. (Which religions prohibit vaccinatiion, anyway?)

  • comment avatar Shavano September 2, 2012

    The danger is not to your vaccinated children. The danger is to third parties, mostly babies like those described in the article and to the elderly whose immune systems may no longer hold immunity and who are less able so survive a serious infection.

    Babies are normally vaccinated at 15-18 months. Parents of newborns and young children should be informed that until their child can be vaccinated, they are at risk of several life threatening diseases and that they should avoid unvaccinated children and adults whenever possible. Parents should inquire as to the vaccination status of their older childrens’ playmates and classmates. Unfortunately, the schools cannot tell you who puts your baby at risk. What they COULD do is put pertussis tests in the nurse’s office, test every kid who coughs or sniffles and give quarantine orders to every kid who tests positive for pertussis.

    Parents who refuse to have their children vaccinated should be informed at the time that their children are at unnnecessary medical risk and are dangerous to the health of others and should not be allowed near children under 2 years of age, their older siblings or parents or other unvaccinated children or people over the age of 70.

    Right now, the problem is significant but manageable. 735 cases out of the about 118,000 children under age two means that unless things improve, a baby born today has about a 1% chance of developing whooping cough before he or she is immunized. Less if you can limit exposure to potential carriers.

  • comment avatar Shavano September 2, 2012

    I don’t care if people have religious objections to immunization. If parents don’t want their children immunized, they can send their children to private schools (if they can find one that accepts unvaccinated children) or home-school them.

  • comment avatar Jolene September 2, 2012

    No, my son is vaccinated and still got it TWICE this year. He got it once before the series started and again a week before the last shot. I suspect he’s starting to get it AGAIN so I have a hard time believing the damn shot even works.

  • comment avatar Jaime September 2, 2012

    Thank you for posting! I’m 6.5 mos pregnant and will be asking my doctor about a booster!!

  • comment avatar Kayla September 3, 2012

    I’m thankful having had two preemies prior to 32 weeks that neither of our daughters have gotten it or anything major for that matter. IMO, your best bet in protecting against pertussis is thorough hand washing and breastfeeding. I can honestly say I’m not surprised that so many kids are getting it. I rarely see parents wash their toddlers hands in rest rooms and most who do, don’t do it properly. Also… People are gross. How many parents teach their kids to cover their cough with their hands? Our daughter has been coughing into her sleeve since before she was 18 months old, it’s possible.

  • comment avatar Holly September 3, 2012

    If parents don’t want to immunize their kids, whatever, just keep them away from my kids when they are sick! I’m so cautious when my kids are sick to warn other parents and take them to the doctors to make sure they aren’t contagious before going back to preschool or other events. I just wish others cared more too. I had one parent laugh as their kid sneezed in my kids face. I was so annoyed. My kids were super sick for two weeks after. GAH!

  • comment avatar Kayla September 3, 2012

    Holly, I agree. Kids have no business being out in public when they have snot running down their faces or can’t properly cover a cough.

  • comment avatar Holly R September 3, 2012

    Older folks are getting it too! Remind your parents and grandparents to check if they need a booster shot. Very dangerous!

  • comment avatar Gaynia September 3, 2012

    So true Holly R! It’s called the 100 day cough for a good reason!

  • comment avatar Linn September 5, 2012

    I’ve been hearing that more and more pediatricians are refusing to accept or keep non-vax children for the safety of the rest of their patients. If it becomes harder for non-vaccinated children to get care, maybe that would be the final motivator.

  • comment avatar Isaac September 11, 2012

    There are a lot of diseases coming back that were previously ‘cured’. Thank goodness for the Public Health Department system which people denigrate.

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