Christopher Rosacker

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September 18, 2013
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County leads California in whooping cough cases

Nearly nine months after an outbreak was first reported, pertussis, also known as whooping cough, continues to plague western Nevada County, which tops the California list in case proportions, county officials declared Wednesday.

“We still have the highest case rates for counties per 100,000 population,” said Ken Cutler, Nevada County’s health officer.

A total of 72 people have been diagnosed with whooping cough since the first month of the year, and 54 of them have been school-aged, according to the Nevada County Public Health Department in a memo to parents of area school children Wednesday.

But Cutler said a promising indicator has developed.

“We’ve now gone more than three weeks without a report of a new case. It’s not clear exactly why that is,” Cutler said, noting the significance of the time frame coinciding with the start of the school year. However, Cutler is reluctant to declare the outbreak contained.

“In the first couple weeks of school, there is often a lot of cough illness, and pertussis isn’t recognized early because people mistake it for a cold,” Cutler said.

Whooping cough is very contagious, making containment a challenge. People with whooping cough are contagious from the start of their symptoms until three weeks of cough or until they have been treated with an appropriate antibiotic for five days, according to the Health Department. After exposure, symptoms usually appear seven to 10 days later, but cases have been reported where symptoms did not surface until up to 21 days later.

People with whooping cough may have coughing spells in which they can’t catch their breath between coughs, health officials cautioned. As they catch their breath at the end of a coughing spell, they may loudly gasp — a “whoop” — and vomit or feel like they are choking. There is usually no fever with whooping cough.

Infants are at the greatest risk for pertussis and for having severe complications from it, said Tex Ritter, interim director of Public Health, in a previous interview with The Union. More than half of infants younger than a year old who are infected with pertussis are hospitalized, and about one of every 200 babies dies. Most infants diagnosed with pertussis get it from a household contact, often the mother. Young babies with whooping cough may not have a cough but may have trouble breathing and gag, gasp, turn color or vomit, cautioned the Health Department.

Nevada County has long had low immunization rates with many teens and adults lacking the recommended Tdap booster for whooping cough, according to the Health Department. Unvaccinated and under-vaccinated people are at higher risk for the infection and for more severe infection. Transmission of the disease is 80 percent likely when an unvaccinated person comes in close proximity to an infected agent, according to Cutler.

“While we have low immunization rates, it is important for people to get immunized,” Cutler said.

The vaccine usually protects against whooping cough but is not 100 percent effective, and immunity from the vaccine lessens over time, according to the Health Department.

“To protect your health and the health of our community, please check your and your child’s immunization status and get any needed vaccinations or boosters,” the Health Department told parents Wednesday. “It is now recommended that women receive a whooping cough booster with each pregnancy.”

If a child has symptoms of whooping cough, it is recommended that they not go to school until evaluated by a healthcare professional. If pertussis is suspected and the cough has been for less than three weeks, the child should be excluded from school and activities until a lab test has ruled out pertussis or until five days of antibiotics are completed or until 21 days from cough onset, if there is no testing or treatment, according to the Health Department. Treatment and school exclusion are not recommended after that time, although the cough may persist for much longer.

The Nevada County Public Health Department will continue to investigate the outbreak and work closely with the schools, it said. More information on whooping cough is available on the California Department of Public Health website at The school contact for more information is Sharyn Turner, Nevada County Superintendent of Schools health coordinator, who can be reached at 530-478-6400.

To contact Staff Writer Christopher Rosacker, email or call 530-477-4236.

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The Union Updated Sep 23, 2013 03:39PM Published Sep 22, 2013 02:18PM Copyright 2013 The Union. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.