Whooping Cough Inflicts Its Damage Official Says 3-Week-Old Outbreak Is Worst She’s Seen In 24 Years

In just three weeks, whooping cough has done as much damage in North Idaho as it did in three months during the Panhandle’s worst outbreak of recent years.

“I’ve done this job for 24 years and I’ve never seen anything quite like this,” Marie Rau, Panhandle Health District nursing supervisor, told the district’s Board of Health Tuesday.

The pace of new pertussis cases, also known as whooping cough, slowed in North Idaho Tuesday, but started to pick up in Spokane County.

The number climbed by three cases to 164 Tuesday in North Idaho and 24 cases were reported in Spokane. The Panhandle Health District over-reported cases on Monday.

During the outbreak of 1994-95, pertussis struck 174 people over three months in North Idaho. This year, more than 300 cases of pertussis have been reported statewide.

When the board asked Rau how long the outbreak would last, Rau responded, “How high is up?”

Thousands of people have been contacted because of the epidemic and most of them are on preventive antibiotics. The preferred antibiotic, erythromycin, is expensive and makes some people nauseous.

“Some people start vomiting and can’t take it. Some people just feel yucky,” said Richard McLandress, a family physician and member of the board.

Because of cost and the side effects, some infected people stop taking the medication. That, and the fact that some people won’t remain in isolation when they’re sick, is hindering efforts to stop the disease from spreading, health officials said.

Half of the confirmed cases are adults, Rau said. Most Coeur d’Alene and Post Falls schools have reported cases.

Two cases of pertussis have been confirmed in Spokane public schools - Holmes Elementary and Audubon Elementary.

Parents of those children’s classmates were notified today of the whooping cough exposure.

“We’re … asking those people to see their physicians and to do that before coming back to school,” said Carol Murphy, health services coordinator for Spokane School District 81.

Varied treatment is recommended for children in the same classrooms as the infected kids.

Children who appear completely well and adequately immunized for pertussis are given a 14-day course of antibiotics.

Students who appear well but are inadequately immunized are tested, placed on antibiotics and kept home until the test results are available.

Children with symptoms - runny nose, runny eyes, sniffles, etc. - are tested, placed on antibiotics and kept at home until test results are available.

Children who test positive don’t return to school for five days after beginning antibiotics, said Murphy. That’s when pertussis is no longer contagious.

“It’s going to run its course, probably,” said Murphy.

Idaho’s state epidemiologist, Dr. Christine Hahn, is in Coeur d’Alene today to share her expertise with doctors and school officials on fighting pertussis. Hahn recently returned from a visit to the Centers for Disease Control and Prevention in Atlanta where she met with pertussis experts.

The Panhandle Health District Board formally approved the creation of a special task force Tuesday, headed by McLandress, to tackle the difficult job of preventing outbreaks.

The task force won’t meet until the current outbreak is more under control, McLandress said.

“All of us in medicine are just totally overwhelmed by this,” he said.

Health officials blame the epidemic on Idaho’s low immunization rate. According to the CDC, Idaho’s statewide rate is 66 percent - the worst in the nation.

“We think there’s 2 percent who have a strong stance against it. I don’t think we’ll change their mind,” Bock said.

Rau suggested focusing efforts on people who intend to vaccinate their children but just haven’t gotten around to it.

Testing in Coeur d’Alene continues today from 10 a.m. to 7 p.m. at 1111 Ironwood Drive. People with symptoms and who have been in direct contact with a known pertussis victim should be tested.

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This sidebar appeared with the story: ABOUT PERTUSSIS: Pertussis is caused by a bacteria that lives in the mouth, nose and throat of people infected. Symptoms are a runny nose, sneezing, low fever and a persistent cough. It’s spread on the moisture of human breath and the droplets from sneezing or coughing. The incubation period is six to 20 days. People who have had direct contact with a pertussis victim AND have symptoms should be tested. Preventive antibiotics are recommended for household members and close contacts of pertussis victims regardless of their immunization status. People with symptoms who don’t know whether they have pertussis should avoid gatherings and children. Just because one family member has been exposed to a pertussis victim does not mean everyone in the family needs to be tested or take antibiotics. Only those in direct contact with pertussis may need medication or testing. Immunization against pertussis is 70 to 90 percent effective in children. The disease isn’t as severe in children who have been immunized. Adults and teenagers, whose immunity may have worn off, can be infected. Health officials urged parents to get children under age 7 immunized and accelerate their immunization schedule during the outbreak.