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Outbreak Could Have Been Worse Cdc Says Immunization Softened Effects Of North Idaho Epidemic

Wed., Oct. 22, 1997

As drastic as North Idaho’s whooping cough outbreak was last spring, it actually was a mild epidemic.

Although an infant was killed by runaway pertussis bacteria, most people suffered only minor symptoms of the disease and only four people were hospitalized.

That’s one conclusion of a report presented in Coeur d’Alene Tuesday by the Centers for Disease Control and Prevention.

The CDC sent a 17-member team to North Idaho this summer to study the outbreak. Two members returned this week to present their findings to the Panhandle Health Distict and a local task force on immunizations.

The task force was formed by the health district’s board of directors following the outbreak. Its goal is to improve immunization rates in North Idaho.

Dr. Mehran Massoudi of the CDC said the outbreak would have been worse if the immunization rates had been lower.

“What you want to do is drive coverage (immunization rates) to the ceiling,” Massoudi said. “There’s no reason we can’t achieve that.”

Dr. Richard McLandress, a local physician, said he was surprised that immunization rates among children involved in the outbreak were as high as they were.

Although Idaho’s immunization rate is 68 percent, among the lowest in the nation, the CDC found that most of North Idaho’s young pertussis victims were fully immunized.

Of the 54 confirmed cases involving children 6 years and younger, only five weren’t up-to-date on their immunizations.

The reason vaccinated children could get pertussis is that the vaccine is only 70 percent to 90 percent effective. There is no pertussis vaccine that’s effective for people 7 years or older.

That doesn’t mean children shouldn’t be immunized, Massoudi said.

“What the vaccine does for you is make the symptoms less severe,” he said. “The unfortunate death in this community was in a child who was not vaccinated.”

The infant was scheduled to have his first pertussis vaccine, normally administered at three months, but died before the appointment.

To be fully protected, children need three doses of the vaccine.

The schedule calls for the third dose at 12 months.

“It works like a seat belt,” Massoudi explained. “It may not prevent an accident, but you won’t die.”

Almost all deaths from pertussis, nationwide, are in children younger than 1 year old, he said.

In its study, the CDC focussed on where children get their immunizations and at what point they fall behind their immunization schedule.

The results showed that most children in the area get their shots from a private provider. Children who access public health care tend to have lower immunization rates, but all vaccinations - from public and private sources - tend to drop off as a child grows older.

Most children on public assistance are involved in the federal Women, Infants and Children program. CDC found an increase in immunization rates among those children after their six-month visit with WIC.

“They’re coming into WIC,” Massoudi said. “We need to capture them while they’re there.”

The CDC also advised working with private clinics to increase immunization rates.

Massoudi said the study found that less than 1 percent of the general population in North Idaho currently refuses to be vaccinated.

The immunization task force, headed by McLandress, decided to form three working subcommittees to tackle the pertussis problem.

One committee will address working with the WIC program to improve vaccination rates among children on public assistance.

Another committee will look at private practices and how to increase vaccinations there.

A third committee will study how to centralize vaccination records so that if a child goes to different providers, there’s one place to access accurate information about the child’s immunization history.

The “registration system,” as it’s called, could help providers to remind parents when their child’s next vaccination is due.

To date, Idaho has had 479 pertussis cases, both confirmed and probable. Of those, 172 were in North Idaho.

, DataTimes ILLUSTRATION: Color Photo


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