January 16, 1998 in Idaho

New Test Gives Better Look At Whooping Cough Officials Can Use Local Labs To Test For Pertussis Instead Of Having Analysis Done In Boise

By The Spokesman-Review
 

A new test for pertussis is giving health officials a better idea of the number of actual cases in North Idaho.

As of Thursday, the Panhandle Health District had 52 positive tests for pertussis since Dec. 1.

But health officials are stopping short of calling the latest string of illnesses an “outbreak.”

“An outbreak is anything above your endemic (normal) level,” explained Marie Rau, PHD nursing supervisor. “The next question is always what is your regular endemic level.”

The health district doesn’t know what the actual “normal” occurrence of pertussis in North Idaho is, although Rau suspects it’s a higher number than what typically is reported.

“One of the reasons we have more cases is that we’re looking for it really hard,” she said.

The new test is a more precise tool. With most tests, the district’s own lab grows a culture to determine whether someone has pertussis, commonly known as whooping cough. The new test, which has been available only about a month, replaces an analysis in the state lab in Boise.

While it helps gather information, the test doesn’t do much in terms of preventing an outbreak because the results take from four days to three weeks. Rau said most of those people are put on antibiotics anyway as a precaution.

The latest rash of pertussis victims came at the tail end of the worst year for the disease in Idaho’s recent history.

Idaho had at least 584 cases of pertussis in 1997, according to the Department of Health and Welfare. Of those, 224 were in the Panhandle. In 1996, 115 cases were reported statewide.

As with last spring’s outbreak in North Idaho, the recent cases have prompted the health district to recommend an accelerated immunization schedule for children.

“If babies get it, those are the ones we worry about, and those are the ones we’re trying to protect,” Rau said. She also suggested that babies should not be in day care until they’ve been fully immunized.

“We know how strapped people are. … What are these parents going to do?” she said. “But the truth of the matter is that infants under six months probably should not be in day cares, and all people with respiratory illnesses should be isolated. We all know the implications of that.”

Vaccination critics question the need for the vaccine when 86 percent of the pertussis victims last spring had been immunized. The vaccine loses its effect on older children and adults and does not completely prevent pertussis.

Dawn Winkler, vice president for Concerned Parents for Vaccine Safety in Cheney, is as much concerned about the risk of side effects from the vaccine as she is from pertussis.

“It’s a risk either way,” she said. “You’re jeopardizing an infant that’s too young to handle the vaccine in the first place.”

While reactions to vaccines are not commonplace, they do occur. For the past year, parents have been able to request an a-cellular pertussis vaccine that’s believed to be safer than the old vaccine.

Health officials believe that immunizing early gives children at least some immunity, as opposed to none at all. A Centers for Disease Control study showed that very few people suffered complications from pertussis in North Idaho. The only death was in a baby who was too young to be immunized.

The agency attributed the low number of complications to the high number of people immunized.

“I understand the skepticism with pertussis,” said state epidemiologist Christine Hahn. “There are so many triumphs in public health, but pertussis is like this war that’s at a stand-off. It doesn’t seem like it’s going away.”

, DataTimes

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