The whooping cough outbreak in Kootenai County is hardly the biggest in the state’s recent history, but it is the only one that has proved deadly.
Health officials have tested 100 or more people for pertussis, commonly known as whooping cough, since they learned that a 2-month-old Post Falls boy who died two weeks ago had the disease.
They’ve found children in three day-care centers and one public school with pertussis and have warned parents of pupils at Post Falls’ Ponderosa Elementary School to be on the lookout for symptoms.
In all, the count of confirmed cases late Tuesday stood at nine, including the fatality. Another likely victim, a 9-year-old child, was identified Tuesday afternoon.
“We’re hoping that we’ve stopped this one earlier” than past outbreaks, said Jeanne Bock, director of family and community health for the Panhandle Health District.
But health officials won’t know until they’ve tested everyone who has had contact with a known pertussis victim.
“It’s a lot of people,” said Marie Rau, nursing supervisor. “Over this lunch hour, I did eight myself.”
The test involves inserting a cotton swab through the nose to retrieve a sample from the back of the throat.
“It takes about 20 seconds,” Bock said. “It’s not that long, but it is uncomfortable. It’s hard to sit still.”
Last week, the health district believed that the disease was confined to the immediate contacts of the 2-month-old child - his family and an in-home day-care operation in Post Falls with 16 children.
Because health officials thought they could contact all infected parties, they did not issue a public advisory.
But Friday evening, two more cases surfaced; a 2-year-old who attends KMC Kids day care at Kootenai Medical Center and another child who goes to an in-home day care in Coeur d’Alene that serves eight children.
The 2-year-old’s sibling, who attends second-grade in Ponderosa Elementary School, also was diagnosed with pertussis.
The parents of the student’s classmates received letters Monday from school and health officials advising them to contact their doctors about the possibility of having their children placed on preventative antibiotics.
The latest probable victim is a 9-year-old student who rides the same school bus as the second-grader.
The school and health district took numerous calls Tuesday from concerned parents.
“I would be concerned, especially if I have children who are infants who haven’t been vaccinated,” Bock said. “They are the most at risk.”
There’s only been one case of whooping cough diagnosed this year in Spokane County, months ago.
Although a number of people in Spokane were exposed to the Kootenai County cases, none of them have shown any whooping cough symptoms, said Paul Stepak, epidemiologist for the Spokane Regional Health District.
In contrast, Idaho has had 100 cases so far this year, compared with 40 cases to date in 1996.
“We have had reports of pertussis pretty consistently from all over the state in the last three or four years,” said Merlene Fletcher, state immunization program manager. “When you have immunization rates in the neighborhood of ours (61 percent statewide), you will be susceptible to outbreaks.”
The worst outbreak in recent years was in North Idaho at the end of 1994 and early 1995, with 173 cases. The second largest outbreak since 1993 was last year in the Panhandle, when about 80 people were diagnosed with pertussis.
In those two outbreaks, however, no one died.
Day-care operators declined to be interviewed Tuesday, but KMC spokesman Mike Regan said that KMC Kids was closing the 2-year-old room for a week and advising parents of children with symptoms to have them tested.
On average, KMC Kids has 60 children in its care. But Regan believes their exposure was limited because since mid-March the infected child had either been at home or in the hospital’s day care facility for sick children.
The symptoms for pertussis are similar to a cold or allergies - runny nose, sneezing and coughing. After a couple of weeks, the pertussis victim’s cough will worsen into violent coughing spasms, followed by a characteristic whoop.
The most contagious time is during the early stages, when it’s hardest to distinguish from other ailments.
To keep young children from catching the disease, health officials are advising parents to speed up the immunization schedule. Instead of two months, babies should get their first shot at six weeks.
“As far as I’m aware, there’s no health affects to immunizing early,” said Dr. Christine Hahn, state epidemiologist. The reason to wait until two months is primarily because the child’s body is more capable of developing long-term anti-bodies, she said.
“Because there’s pertussis in the community, at least you’re getting something into them for the moment that will protect them as this is going on.”
As for other advice, “we’d just like people not to panic,” Rau said. “If they do show symptoms, they should keep their respiratory secretions to themselves.”
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