Whooping cough in school in New York

mama_d, BSN, RN · Jun 9, 2012

I'm in Missouri, apparently we've had over 200 cases this year (compared to 99 by the same time last year). Same article (at kmox.com) says that Washington state has declared an epidemic.

I know my kids' pediatrician has been pushing for all the parents of her patients to get the Tdap booster for years. Scary that stuff like this is being seen in such large numbers when we've got a vaccine for it readily available.

ShayRN · Jun 9, 2012

I think we are seeing a resurgence of these childhood illnesses because of the continuing belief that immunization injections cause autism. It amazes me the despite continued studies and proof that the original report of the connection was false, people continue to believe this myth. 100,000 scientists say there is not proof, but Jenny McCarthy says it is connected & people believe her. We are now seeing the ramifications of not requiring the immunizations in our schools.

allnurses Guide · Jun 9, 2012

California passed a law for this last year stating at the start of school kids 7th grade to 12th grade must have proof of recent Tdap.

It was a nightmare trying to get millions of kids immunized but we did it.

www.shotsforschools.com was a great help.

Cleaning and disinfecting won't help. That's crazy.

roser13, ASN, RN · Jun 9, 2012

The first group of parents that refused vaccines got lucky - their kids escaped serious illness due to the herd effect. Those parents preached the "go bare" philosophy to other parents (think Jenny McCarthy) and now "the herd" is coming down with critical illness that could have truly been a thing of the past.

Esme12, ASN, BSN, RN · Jun 9, 2012

From your other post.....My response.

Pertussis outbreaks occur across the country every year. Once infected the cough can persist for months.

The CDC estimates that there are epidemic outbreaks every 3-5 years. CDC - Pertussis: Outbreaks

Localized outbreaks of pertussis are not uncommon and occur throughout the year. Some examples of pertussis activity in the US include:

In Washington, there have been 2,092 cases reported statewide through June 5, 2012, compared to 164 reported cases in 2011 during the same time period. There were 965 cases reported statewide in 2011 compared to 608 reported cases in 2010. Visit the Washington State Department of Health for the most recent information.
In 2010, 9,143 cases of pertussis (including ten infant deaths) were reported throughout California. This is the most cases reported in 63 years when 9,394 cases were reported in 1947 and the highest incidence in 52 years when a rate of 26.0 cases/100,000 was reported in 1958. Previously, the peak was in 2005 when there were 3,182 cases reported. In 2011, disease activity was at relatively increased levels throughout the state. Visit the California Department of Public Health website for the most recent information.

The treatment is with antibiotics and a good cleaning. Outbreaks at middle and high schools can occur as protection from childhood vaccines fades. In school outbreaks, prophylaxis is recommended for close classroom and team contacts — and the pertussis booster vaccine (Tdap) depending on age. Pertussis outbreaks in hospitals and other clinical settings can put infants and other patients at risk.

The Tdap is about 80% effective against infection in infants and children and about 70% effective in adults. It doesn't necessarily prevent infection but will produce a mild form.

CDC - Pertussis (Whooping Cough) homepage

Vaccines and Preventable Diseases:

Pertussis (Whooping Cough) Vaccination

Pronounced (per-TUS-iss)

Vaccines: VPD-VAC/Pertussis/main page

I hope this helps.

LollygaggerRN · Jun 9, 2012

I am a school nurse in WA- where we are having the "epidemic". We are taking it very seriously, although, truthfully it is difficult to do much more than inform people and encourage them to get vaccinated.

This particular outbreak also seems to be affecting people who have been immunized, which I find tragic. I personally have dealt with a couple of students in this situation- they do everything right and then....shazzam.....end up with it anyway. I am hoping maybe they just got a bad batch of vaccine or something..................

gummi bear · Jun 10, 2012

But some of these children are teenagers. So they don't fit into the "Jenny McCarthy" theory that started a few years ago.

dream'n, BSN, RN · Jun 10, 2012

But some of these children are teenagers. So they don't fit into the "Jenny McCarthy" theory that started a few years ago.

You are correct. The reason for the huge increase in pertussis cases for the past several years is waning pertussis immunity. Until the licensing of Tdap in 2005, tetorifice boosters for those over the age of 7 did not contain pertussis. Therefore preteens, teens, and adults did not carry immunity. Prior to 2005, only children up through age 7 received pertussis in the tetorifice vaccine, leaving large parts of the population unprotected. This is what has directly led to the resurgence of the disease. The health care community is now playing 'catch up' trying to immunize those that lost immunity so long ago. Why did the CDC not recommend pertussis be included in tetorifice boosters long before 2005; I don't know. But it does frustrate me. Many people, especially very little ones that had not reached the usual vaccination age for tetorifice/diphtheria/pertussis have died because of the resurgence of the disease. Therefore, this is the fault of research/surveillence/regulation; not parents.

That's my :twocents:

Hay Nars, RN · Jun 10, 2012

This is the kind of thing that happens when parents are uneducated and refuse/don't allow their child to get the vaccinations which can prevent most of these diseases. These vaccinations are pretty much free at a health department and do more good than bad (unless in some really unlucky cases with side effects of medication, etc).

Just because the child down the street had a reaction doesn't mean your little billy joe will have the same reaction. Oh well, hope all goes well there!

BluegrassRN · Jun 10, 2012

This is the kind of thing that happens when parents are uneducated and refuse/don't allow their child to get the vaccinations which can prevent most of these diseases.

I disagree with this. It's easy to blame non-vaccinating parents, but the reality of this epidemic is more complex. Across the country, the lack of boosters in immunized children and adults is the main contributer. In immigrant communities, often the lack of any sort of organized immunization schedules and general health care access are large contributors. In very few areas have studies actually shown that lack of immunization by parents who specifically refused immunization contributes significantly; they're just an easy scapegoat.

My husband and two daughters contracted pertussis one fall several years ago. My youngest was 7, my oldest was 10. Both were immunized against it; as a matter of fact,

due to a variety of issues, my youngest did not receive and complete the series until about a year before she contracted it. Every person in our schools who contracted it was adequately immunized.

The pertussis immunization has some of the lowest efficacy rates amongst immunizations. Somewhere around 85%. That leaves a large number of individuals appropriately immunized but still at risk for contracting it.

zumalong · Jun 10, 2012

Most of the children who have the disease are current with tdap vaccine. But even if they were behind, I would think that chd would offer to community. My concern is other schools that were exposed during sports sectionals and may not even know. Letters were sent home to our school children only. And media was not aware of outbreak until Friday and superintendent and chd did not discuss how many of the children were on the baseball, lacrosse, and soccer teams Many parents continue to send ill children to school because we have state tests and finals. No one else sea to be taking this seriously.