February 22, 2013 - The Nevada County Public Health Department has received a third report of confirmed Pertussis (Whooping Cough) in a student at the same class as the previous confirmed cases at Yuba River Charter School. In addition, students at Nevada School for the Arts in the same class have also been diagnosed with Pertussis. Both schools have low vaccination rates. The health department continues to work with the schools and the local providers in identifying additional cases. Treatment of Pertussis decreases transmission of the disease to others. Infants are at the greatest risk for getting Pertussis and having severe complications from it. According to interim Public Health Director Tex Ritter, more than half of infants younger than 1 year-old who are infected with Pertussis are hospitalized and about 1 out of every 200 babies with Whooping Cough dies, so protecting infants is critical. Most babies who get Pertussis get it from a household contact, often the mother. That is why those who are pregnant or live with or care for babies are such a high priority for vaccination.
Most adults in the US have not been vaccinated against Pertussis as many Americans don't know that immunity from the vaccine (or from the illness) wanes with time and a booster is recommended. Pertussis vaccines are recommended for people of all ages. Infants and children should receive five doses of DTaP for protection. Doses are given at 2, 4, and 6 months, then between 15-18 months, and again at 4-6 years of age. A booster dose of Tdap is given to pre-teens at 11 or 12 years of age. Any adolescent or adult who did not receive Tdap as a preteen is recommended to get one dose. Getting Tdap is particularly important for pregnant women and others who care for infants. A new recommendation is that pregnant women receive a Tdap with each pregnancy between 27 and 36 weeks gestation.
Pertussis is a bacteria that spreads easily from person to person through coughing and sneezing. Outbreaks of Pertussis in schools, daycares, and other institutions are not uncommon as Pertussis often goes unrecognized and untreated especially in teens and adults because it starts off looking like an ordinary cold. Unvaccinated children are at least 8 times more likely than fully vaccinated children to get pertussis, according to Dr. Ann Schuchat at the Centers for Disease Control. Nevada County has the lowest vaccination rate at kindergarten entry in California and some schools have some of the highest rates of Personal Belief Exemptions for vaccinations in the state.
About 90% of children who receive the first 5 doses of vaccine have good immunity against Pertussis but that immunity wanes so that five years later that protection drops to 70% and continues to decline until a booster is given. The booster is about 75% effective and it is not clear how long immunity lasts with it. Vaccination does decrease the severity of the disease and decreases the spread to others. The Nevada County Public Health Department encourages people to talk with their health provider to ensure that they are up-to-date with their vaccinations.
Editor's Note: This news release comes on the heels of the first report on confirmed cases of Pertussis outbreaks at the Yuba River Charter School: "According to Holly Whittaker, Epidemiologist at Nevada County Public Health, the kindergarten vaccination rates for the Yuba River Charter School is 18.64% for the most recent school year. Nevada County's vaccination rate is 71.58% and the state vaccination rate is 91.0%."
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