Stanislaus schools warned to watch for illness

Stanislaus County health officials are urging schools to watch for signs of whooping cough in the student population and to help inform parents to take precautions.

Officials worry the contagious illness that has sickened more than 3,300 people in California could spread in schools. Stanislaus County has reported 92 cases of whooping cough this year, the highest number of cases since outbreaks occurred in 2005.

The epidemic in California has claimed the lives of eight infants, including a 4-week-old baby in Stanislaus County. All of the victims were less than 6 months old.

More than 40 percent of cases in Stanislaus County have been school-age children, said Dr. John Walker, county public health officer. The sufferers have ranged from 3 weeks to 83 years old, with a median age of 11.

The county sent a public health advisory to schools this week, asking them to notify staff and give information about the epidemic to parents.

"We want parents to be aware of what the illness is like, what precautions to take and to be aware of the need for vaccination updates," Walker said. "Parents usually read the letters that are sent home from school."

Whooping cough, also known as pertussis, is a respiratory bacterial infection that causes severe coughing fits. Symptoms may be similar to a cold for a week or more, then the sufferer begins to have rapid coughing fits sometimes ending with a whooping sound.

Children are given three diphtheria-tetanus-and-pertussis vaccinations when they are infants and two more before they enter kindergarten. However, the immunizations are known to wear off.

Faced with possibly the worst pertussis epidemic in 50 years, state health officials are asking parents to consider the tetanus-diphtheria-pertussis booster shot for children 7 years and older. It should be considered especially if the child has an incomplete history of the DTaP vaccination, officials said.

An updated vaccination previously was recommended when children were 10 to 12 years old. The booster shots are available from private physicians or county immunization clinics.

Diane Sutton, a nurse at Shackelford Elementary School in south Modesto, said Wednesday that the school sent information about whooping cough to parents in English and Spanish. Parents were referred to the county's vaccination clinics.

"We are very aware of it," Sutton said, adding that the school's attendance office had no reports of whooping cough.

Medical groups such as Cornerstone Family Practice in Modesto were offering voluntary booster shots to their health care workers. Most of the Cornerstone staff rolled up their sleeves for a shot.

"They are exposed to more people with coughing illness," said Dr. Robert McGrew of Cornerstone. "They might get it personally, and we don't want them to expose the public."

McGrew said the county's 92 cases are only the ones reported, and he believes there are more. Earlier in the year, two school-age children who never had been immunized were treated in his office for persistent coughs, he said.

Pertussis is hard to diagnose. A specimen needs to be taken from the back of the child's nose and the cultures are not always positive, McGrew said.

Infants are vulnerable until their first three vaccinations take effect after six months. For that reason, health officials have stressed vaccinations for those who could spread the germs to infants: mothers, fathers, hospital workers and other caregivers.

Government health officials have eased off the standard protocols for the TDaP booster shots. It's now suggested for pregnant women in their second or third trimesters, and can be given to people 65 and older, such as a grandmother helping to care for an infant or a volunteer in a church nursery.

For those who have whooping cough, antibiotics are most effective when given in the first two weeks -- when it's hardest to diagnose. After that, the treatment will improve symptoms and keep the illness from spreading to someone else, but the patient still may cough for a long time, McGrew said.

The illness spreads when an infected person coughs or sneezes and others come in contact with the droplets. People can take precautions such as regular hand-washing and coughing into their sleeve.

Bee staff writer Ken Carlson

can be reached at kcarlson@modbee.com or 578-2321.