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Scientists probe pertussis cases
CDC experts seek reason for high number in county
Herald Staff Writer
Photo by YODIT GIDEY/Herald
From left, Dr. Sema Mandal, with Centers for Disease Control and Prevention, Bari Wagner, a communicable-disease nurse at San Juan Basin Health Department, and Matt Griffith, an epidemiologist with the CDC, discuss research on pertussis cases in the area at the health department Wednesday.
For more information
Information about pertussis and pertussis vaccinations is available at www.cdc.gov.
Information about low-cost pertussis vaccinations in La Plata County is available at the San Juan Basin Health Department. Immunizations, including those for pertussis, are given every Monday at the health department. Call 247-5702 to make an appointment.
Anyone with symptoms of pertussis – fever, sneezing, runny nose or cough – should contact a physician.
"It warrants investigation because of the wide spectrum of symptoms atypical of pertussis," Dr. Sema Mandal said Wednesday during an interview at the San Juan Basin Health Department.
La Plata County registered 55 of the 146 - 38 percent - confirmed or probable cases of pertussis in Colorado in the first two quarters of 2009.
Pertussis also is known as whooping cough.
It's not unusual for the CDC to investigate unusual trends such as the extraordinarily high number of pertussis cases, but they do so only at the invitation of state and local health authorities, said Matt Griffith, a CDC epidemiologist.
A CDC team visited the Four Corners in 1993 during a hanta virus outbreak and more recently sent a team to New York to help with investigation into H1N1 (swine) flu, Griffith said.
Experience has taught the CDC that it's important to get detailed histories of illnesses and not to rule out anything, Mandal said.
"In this situation, with a mix of classical and nonclassical symptoms, diagnosis can be a challenge," Mandal said.
Sneezing, a runny nose, a fever and cough typically herald the onset of pertussis. A regimen in which children are vaccinated at 2, 4 and 6 months of age, then between 15 and 18 months and finally between 4 and 6 years of age confers protection that is 85 to 95 percent effective.
Protection diminishes with time, and even fully vaccinated children can get the disease. Children ages 11 and older and adults also should be vaccinated against pertussis.
In many of the La Plata County cases in which children and adults tested positive for pertussis, the symptoms were mild or not accompanied by the telltale whooping, which lends the disease its popular name.
Given the absence of the wracking cough and the fact that pertussis is hard to diagnose, the CDC team is looking for other bugs that could cause illness, Mandal said. Pertussis is caused by a bacterium.
"It's too early to speculate what could account for the high number of pertussis cases here," said Mandal, who added that the team had arrived only a week earlier.
She, Griffith and Pam Cassiday a microbiologist, were invited to investigate the pertussis cases by the Colorado Department of Public Health and Environment. They will spend about three weeks in Durango.
The investigators, who are interviewing people who were treated for pertussis, are particularly interested in learning what symptoms they had. They also have contacted three or four local health-care facilities to ask that their patients with new cough-related illnesses take part in the investigation. Participation is voluntary.
Participants fill out a questionnaire that asks about their symptoms, treatment and vaccination history. Also, they are asked for a blood sample and a nasal swab, which are sent to the CDC laboratory for testing.
"People have been incredibly supportive," Griffith said. "It takes about five minutes to complete the questionnaire."
Measures to prevent pertussis in the first place are important, said Bari Wagner, a communicable-disease nurse at San Juan Basin Health Department.
"Make sure your immunizations are up to date," Wagner said. "Practice good hygiene - wash your hands, keep your hands away from your face, cough into a tissue or sleeve and stay home when ill."
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