LOS ANGELES -- Three months after California declared whooping
cough an epidemic, cases have soared to levels not seen in 60 years
and health officials say the potentially deadly disease has yet to
peak in many areas of the state.
There is no single cause for the rapid spread of the infection,
which causes a deep, violent cough that lasts for weeks in adults
but can kill infants and the frail.
Health officials, however, are urging parents to get booster
shots, because the effectiveness of the vaccine fades after five to
10 years, and to get their children inoculated against the disease.
"We still have a small population who don't vaccinate," said
Rosa Vazquez, department administrator for the flu clinic and
immunization services at Kaiser Permanente in Woodland Hills.
"But we get a lot of people over 65 who are getting (the shot).
They've been listening to their children, to the television
messages, and they tell me they remember they had it when they were
a child."
The California Department of Public Health last week reported
6,431 cases and 10 deaths in 2010 from whooping cough, compared
with a record 6,613 cases six decades ago.
The last significant outbreak of whooping cough was in 2005,
when 3,182 cases were reported.
"We honestly don't know (the cause of the epidemic), because
there are several factors," said Mike Sicilia, spokesman for the
Department of Public Health.
Overall rates of infection are highest among Latinos, with about
17 cases per 100,000, followed by whites, with about 14 cases per
100,000, the department reported. Age-specific data, however,
suggest a very high rate among Latino infants.
Latinos composed nearly 80 percent of the infants under 6 months
old hospitalized with whooping cough, the health department
reported in September. And all but one of the 10 deaths reported
this year have been Latino babies.
The state noted that Latino households are typically larger,
exposing infants to more possible sources of whooping cough from
siblings, adults and the elderly.
But concerns that whooping cough has been spread by the Mexican
immigrant community are unfounded, health officials said.
Mexico has no whooping cough cases because children there
receive a much more potent vaccine than those in the U.S., Sicilia
said.
The babies who died were too young to be fully immunized, which
is why state health officials recommended in July that in addition
to parents, pregnant women and caregivers, grandparents also should
receive the vaccine to form a cocoon of immunity.
The federal Centers for Disease Control and Prevention followed
the state's recommendation in September.
Beginning next year, all children entering seventh grade will
have to be immunized against whooping cough, according to a state
law recently signed by Gov. Arnold Schwarzenegger.
Pertussis is a respiratory infection caused by a bacteria that
is spread during uncontrollable coughing spells. The early symptoms
are similar to a cold, but the cough can develop into a deep
whooping sound that can last for weeks and even months.
It can be prevented with a series of inoculations that can be
given to infants as young as 2 months. Adults also can protect
against the disease with a booster shot that became available in
2005.
"Because pertussis was wiped out in the 1980s, many clinicians
are not looking out for this," Sicilia said.
More worrying is that the uninsured or underinsured may have
problems locating affordable vaccine clinics because of state
budget cuts.
"When the state budget was signed (in October), the Infectious
Disease Branch's Immunization program funding was decreased by $18
million," said Debra Rosen, director of public health programs,
chronic disease and health education for the Northeast Valley
Health Corp.
The corporation operates clinics in the San Fernando and Santa
Clarita valleys.
Patients of the clinics can still receive the vaccine, but not
the general public, Rosen said.
"We are referring people to L.A. County public health centers
for immunizations like the whopping cough vaccine," Rosen said.
Response to the recommendations has been positive for the most
part, but local health officials still see some hesitation among
pregnant women and senior citizens.
"We feel that when we talk to our patients about it, they are
open-minded and willing to get the vaccine," said Dr. Marie
Medawar, a pediatrician of Valley Pediatric Medical Group who is on
staff at Providence Tarzana Medical Center.
"There's some resistance from grandparents," Medawar said.
"It's 50-50 among them."
c.2010 Los Angeles Daily News