Colorado’s increase in whooping-cough cases has babies, moms reeling
posted by: Guest Blogger
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.”
Cases of whooping cough, or pertussis, in Colorado through early August
Average number of cases at a similar point in the year
Cases per 100,000 in Colorado this year, higher than the national average
Colorado’s “refusal rate” for infant vaccines
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