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Pertussis rate persists

Jackson County leads state in sometimes-fatal illness

As children begin to settle into a new school year, Jackson County public health officials are still trying to contain an outbreak of pertussis that surfaced before summer vacation began.

As of Monday, 109 cases of pertussis (commonly known as whooping cough) had been recorded for 2003. Jackson County has the highest rate of pertussis infection for any county in Oregon ' 53.8 cases per 100,000 residents.

We have a couple of state epidemiologists working on this with us here, said public health nurse Viki Barbour. Our case rate is 53 times the national average.

Health workers' hopes that the outbreak would wane during the summer ' when children had less contact with each other and spent more time outdoors ' have been dashed by the steady trickle of new cases during the warm months.

— This is still not well contained, Barbour said. We do not feel like we're seeing the end of this.

Whooping cough is known primarily as a disease of young children, but it can infect people of all ages. It's most serious in infants, and can be fatal if left untreated.

An 11-week-old Klamath County baby died of whooping cough in May, and several Jackson County infants have been hospitalized since the outbreak surfaced.

Barbour said the disease continues to spread locally because people do not recognize its symptoms and seek treatment.

It's highly contagious even when the symptoms are minor, she said.

Most people have been infected at home by a family member, but several people have been infected at work, and there were several cases at the Jackson County Jail.

Barbour said some parents have helped the disease to spread by exposing tiny babies to people who are infected. She noted that a 3-week-old infant came down with pertussis this week.

There's nowhere else that baby could have gotten this except from exposure to someone else, she said.

People typically have to spend six to eight hours in close proximity with an infected person to contract pertussis. The bacteria that cause the disease float on microscopic water droplets that are expelled from the lungs when an infected person coughs. The disease spreads when someone inhales those droplets and the bacteria enter the lungs.

Barbour said the majority of the pertussis cases have occurred in Medford, but there have been cases in most other communities as well. There also have been suspected cases in Ashland, where many children remain unvaccinated.

She encouraged parents with infants to minimize their contact with people in general and be especially wary of exposing them to people with cold-like symptoms.

The best thing a parent can do for infants if they're too young to be immunized is to keep them at home, she said. As soon as they're 6 weeks old, vaccinate them.

She said people who have a persistent cough that lasts for weeks should seek medical attention. Our only tool to deal with this is to find people who are sick and treat them so they don't spread it to others.

Reach reporter Bill Kettler at 776-4492, or e-mail

Highly contagious pertussis can occur at any age

Pertussis, also known as whooping cough, is a highly contagious respiratory disease. It is caused by a bacteria found in the mouth, nose and throat of an infected person.

Pertussis can occur at any age. Most reported cases occur in children under 5, but half of those are children under age 1. Between 1993 and 2002, an average of 85 pertussis cases a year were reported in Oregon.

Pertussis begins as a mild respiratory infection, with symptoms similar to a common cold: sneezing, runny nose, low-grade fever, mild cough. Within two weeks, the cough becomes severe and includes episodes of numerous rapid coughs followed by a high-pitched crow or whoop.

Those episodes, more frequent at night, might continue for one to two months. Older people and partially immunized children generally have milder symptoms.

The disease can be fatal if pneumonia develops. Seventy percent of all fatalities occur in infants younger than 6 months.

Source:

The Oregon Department of Human Services Acute and Communicable Disease program.