Wednesday, April 06, 2011

Whooping cough outbreak in Floyd County blamed on lax vaccinations

Blue Mountain School closed after an outbreak of whooping cough among children who never got vaccinated.

At least 23 of the 45 students at Blue Mountain School in Floyd County have been diagnosed with pertussis.

Mia Cueno | Special to The Roanoke Times

At least 23 of the 45 students at Blue Mountain School in Floyd County have been diagnosed with pertussis.

A small, private Floyd County school has closed for the week after more than half its students became ill with whooping cough.

At least 30 people associated with Blue Mountain School have been diagnosed with the highly contagious disease, also called pertussis, including 23 of its 45 students, said Shelly Emmett, the alternative school's director.

The Virginia Department of Health is working with the school to contain the outbreak. While the majority of the cases involve children, a few adult cases have been identified, said Dr. Molly O'Dell, director of the New River Health District.

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Pertussis is an infection characterized by coughing fits that can last for up to 10 weeks, according to the Centers for Disease Control and Prevention. It can cause serious illness and can be life-threatening, especially in infants. It gets the whooping cough name because the violent and rapid coughing can continue until the air is gone from the lungs, forcing an inhalation with a loud "whoop" sound.

The outbreak was caused by not properly vaccinating people against the disease, O'Dell said, noting that a subset of the population does not follow vaccination recommendations.

"For those of us who are advocates of vaccination, this reminds us to stay vigilant," she said. "This is a good wake-up call to remind us why adults and children need to be vaccinated. This is why we advocate for immunization."

There are several components to the anti-vaccine movement. Some people choose not to immunize their children out of concerns that the vaccines cause harm. Others disagree with the recommended timetable, and some cite religious reasons.

Children in Floyd who have the illness were not vaccinated, O'Dell said. With the adults, it could be that they were never revaccinated with a booster shot and their immunity to the disease has waned.

Under Virginia law, schools and day care centers must maintain documented proof that children have received age-appropriate immunizations as determined by the CDC, the American Academy of Pediatrics and the American Academy of Family Physicians. One of the required vaccines is a combination that protects against diphtheria, tetanus and pertussis.

Emmett said several families at Blue Mountain have been granted religious exemptions to the immunization requirements.

"Many of the families and staff at our school understand that some people choose not to vaccinate their children," she said. "We're not requiring that they do."

But she said the school is following the health department's recommendations for reintegrating nonvaccinated or untreated children back into the classroom.

"They've been very cooperative," O'Dell said of the school officials. "They have learned a lot."

Blue Mountain, which offers preschool through middle school education, plans to reopen Monday. But it will not allow students who have not had antibiotic treatment to return until they have been quarantined for 21 days since the last known day of exposure, Emmett said.

"We're asking that families share with us what they have chosen to do with regard to treatment so we can be responsible for reintegrating students and staff back into the school without the possibility of re-exposing people," she said. "We're not taking one stance over another ... but we're setting up guidelines."

Cases of pertussis have been increasing recently in Virginia and nationally. The number of cases in the state confirmed by lab tests jumped 72 percent from 2009 to 2010, O'Dell said.

An epidemic of pertussis in California has led to several infant deaths.

With the growing number of cases, public health experts now recommend that adults get a one-time dose of the combined tetanus, diphtheria and acellular pertussis vaccine to help protect against whooping cough.

It is particularly important for adults who are around young children and infants, according to the CDC.

The first case in the Floyd outbreak was confirmed through a lab test March 30.

Emmett said the school immediately followed the health department's recommendation to keep all family members with a cough or other cold symptoms at home and seek medical treatment for them. She said that she has been in touch with the health department every day and that the school made arrangements to provide the pertussis vaccine and booster shots to staff, students, parents, families and other close contacts.

"They've been very nonjudgmental and just given information," Emmett said of the health department. "It has impressed upon a lot of families that they can seek medical treatment without fear of judgment. I'm very pleased with that."

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