Nevada County schools unaware of some cases of pertussis
March 7, 2013
Although some of the reported cases were not confirmed by lab tests, Nevada County's Public Health Department stands by its report that stated last week at least 11 students have been infected with whooping cough in schools from Nevada City to South County.
A letter has been sent out countywide to school administrators that the outbreak is widespread, as incidents have been reported from Seven Hills, Magnolia, Union Hill, Nevada Union, Yuba River Charter, Nevada City School of the Arts and Bitney College Prep schools. A 12th case was reportedly found with a preschool student.
"Because it is so widespread, it doesn't make sense to contact individual schools; it probably is in all schools in western Nevada County," Public Health Interim Director Tex Ritter said Monday. "When the initial cases occurred and we could identify they were related to one school, we immediately contacted the school. But at this point, it's fairly widespread, and the best thing to do is — if students have a persistent cough — be checked out by a physician."
The reports are confirmed by a doctor and reported, by law, to the public health department, Ritter said.
"When a student tests positive, the hospital or physician is required by law to report to the public health department," he said. "We then do a follow-up to find out where the infection occurred. So we may not notify each individual school. It's probably in all schools, most likely."
Some schools maintained Monday that they did not have a student with an incident of whooping cough.
"I still maintain that as far as I knew, the family doctor stopped short of informing me and the family the young man in question had pertussis. The fact that he was back in school within days without any cough or symptoms whatsoever is indicative of something I would think," Bruce Herring, principal of Bitney College Prep, said in an email. "Perhaps, however, there is something amiss in the system when a doctor can tell the family and school one thing and Public Health another? And Public Health can go to the press without talking with the school administration?"
Magnolia Intermediate also said reports that one of their students had a case of pertussis are not accurate.
"We have two students who brought in doctors' notes saying probably pertussis and/or pertussis exposure. Neither student was tested for a confirmed diagnosis," said Magnolia School Principal Gene Morgan. "One student had received the booster. Both students were put on antibiotics for five days, then can return to school."
Pertussis cannot be detected in a test after three weeks, Randall said, so even if a student's results were negative, he could still have the disease.
"In the case of Union Hill, even though the test came back negative, it's pretty much invalid because they tested him after he had been coughing for more than a month — and the test is only accurate three weeks from onset of symptoms," said Randall.
Nevada County has the lowest rate of immunization in the state, at about 72 percent, compared to the 91 percent average in the state.
Two of the 12 reported cases were with students who had been vaccinated. It's unclear whether two others were vaccinated, Randall said, but the remaining cases were with students who have not been vaccinated.
"I'm guessing probably all but two were completely unvaccinated with no vaccinations from birth on," Randall said.
There is a likelihood that even more cases exist but have not yet been confirmed, Ritter said.
"While a dozen may not sound like a lot, there's a number of suspected cases, meaning not with confirmed lab tests," Ritter said. "There are probably a lot more unreported cases."
Though the disease is most dangerous for infants, the symptoms are long-lasting in adults, and involve a persistent cough and a "whoop" sound upon inhalation. The disease is also infectious for five weeks, much longer than most diseases, Ritter said.
"We haven't had any hospitalizations, but it is preventable, and (it's) best for people to be aware of it because it is widespread in our community," Ritter said. "Even as an adult, you'll have a cough that lasts three months, keeps you up at night. The amount of coughing that happens will keep you from being able to eat. You can't swallow as much. You have a sore throat, are irritated and can't sleep, and you're going to keep up the rest of the household."
A common misconception is that adults have already been vaccinated for pertussis, Ritter said, but the current vaccine has only been available to adults since 2005, Ritter said.
"This is not a cause for alarm, but it is a wake-up call that it is important to get vaccinated, especially if you come in contact with the elderly, people with pulmonary disease, emphysema and infants," Ritter said. "There's always a cause for concern, and we wanted to get the message out that regardless of vaccination status, you can still get pertussis, and you need to be aware of those around you and your own symptoms as well to follow up properly with that."
To contact Staff Writer Jennifer Terman, email email@example.com or call 530-477-4230.
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