New inoculations urged for whooping cough

<p>With children back in school and whooping cough season still reaching its peak, Sonoma County Public Health officials are urging those with out-of-date vaccinations to get new inoculations.</p><p>That means most people over age 10.</p><p>A statewide epidemic of pertussis, or whooping cough, has hit the North Bay hard.</p><p>With about 280 cases, Marin County's rate of infection ranks first in California, while Sonoma County, at 175 incidents, is in seventh place, according to state records. There were about 12 cases in Sonoma County by this time last year, state officials said.</p><p>A single confirmed case of pertussis at Rincon Valley Middle School this week prompted a flurry of activity to ensure it wouldn't spread.</p><p>Middle school families as well as those of all 15,500 students in the Santa Rosa City Schools district are to receive e-mails, computerized calls and letters notifying them of the case and educating them about vaccination recommendations, school officials said.</p><p>Rincon Valley Middle School staffers are on alert for the kind of “energetic coughing” that caught someone's attention Thursday, when a student was sent home and instructed to see a doctor, who confirmed she had whooping cough, Principal Matt Marshall said.</p><p>Two more students were sent home Friday, though there was no word whether they have the disease, he said.</p><p>Though other adolescents and teens were diagnosed earlier in the year, the middle school student was the first in Sonoma County's largest district to become ill this year, invoking its infectious disease protocol.</p><p>“At school, they're in close proximity to one another — 30 kids in a classroom, so we have to be sure they're safe,” Marshall said. “Out at the mall, they have space between them. In a classroom that's not necessarily the case.”</p><p>Pertussis, a highly contagious infection that starts with cold-like symptoms and ususally causes coughing attacks and spasms so severe they can provoke vomiting, is especially dangerous to infants too young to be vaccinated.</p><p>Young children generally are required to be vaccinated by age 5. But there is not a requirement for those 10 and older whose immunizations have begun wearing off or have worn off completely, not, Sonoma County Deputy Public Health Officer Mark Netherda said.</p><p>Moreover, the booster shot that would normally be given to adolescents and adults has only been available since 2005, he said.</p><p>“Most adolescents and adults have not had their booster doses — ever,” Netherda said. “Practically everybody needs one.”</p><p>That makes them susceptible to a painful, lengthy illness that's making its biggest appearance in California in the past 50 years.</p><p>In China, it is called “the 100-day cough,” he said.</p><p>Eight babies under three months old have died in California this year, though there have been no fatalities on the North Coast.</p><p>In Sonoma County, 16 infants have been sickened, four of them requiring hospitalization, Netherda said.</p><p>“That's very worrisome because any time an infant is hospitalized with this disease, their risk of having a severe complication or even dying is very high,” he said.</p><p>Several others have been seen in emergency rooms because of the strangulating spasms that make it so hard for them to breathe, he said.</p><p>The highest rate of infection is in the 11-to-18 age group, where 40 percent of Sonoma County's cases and more than three-fourths of Marin's have hit.</p><p>That's the same age at which immunizations typically given before kindergarten begin to wear off, Netherda said.</p><p>Though Sonoma County has a high rate of failure to vaccinate, most children by kindergarten have received a series of five doses of a combination vaccine against diphtheria, tetanus, and acellular pertussis, known as DTaP.</p><p>Children and others over age 10 would receive a Tdap, also a combined tetanus, diphtheria and acellular pertussis booster.</p><p>Since California is one of only states where the booster isn't required for entry to middle school, many older children and adults haven't had it. The exception is who have needed a tetanus shot, which is usually given in a combination vaccine, or they've been recently seen by a doctor who has insisted on a pertussis booster.</p><p>Though not normally licensed for children under 10, the Tdap booster is being recommended this year by state and county health officials for children as young as 7 if they haven't had the full childhood vaccination series.</p><p>Use of the Tdap booster is also advised for seniors ovr 64 this year because of the epidemic, especially if they have contact with infants, Netherda said.</p><p>“There are some people who <NO1><NO>got their vaccine when they went in and got their tetanus shot,” Netherda said. “If they don't know or know they didn't, it's OK to get a tetanus shot right now.”</p><p>“It's more dangerous to be under-immunized than it is to be over-immunized,” he said.</p>