Pertussis, atypical cases - USA: (CO), RFI
Date: Sun 23 Aug 2009
Source: Durango (CO) Herald [edited]
<http://durangoherald.com/sections/News/2009/08/23/Scientists_probe_pertussis_cases/>
Experts from the Centers for Disease Control and Prevention (CDC) are
in Durango looking for clues as to why an unusually large percentage
of the pertussis cases reported in Colorado in 2009 occurred in La
Plata County.
"It warrants investigation because of the wide spectrum of symptoms
atypical of pertussis," Dr. Sema Mandal said during an interview at
the San Juan Basin Health Department.
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 3 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 3 or 4 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 5 minutes to complete the questionnaire."
[Byline: Dale Rodebaugh]
Source: Durango (CO) Herald [edited]
<http://durangoherald.com/sections/News/2009/08/23/Scientists_probe_pertussis_cases/>
Experts from the Centers for Disease Control and Prevention (CDC) are
in Durango looking for clues as to why an unusually large percentage
of the pertussis cases reported in Colorado in 2009 occurred in La
Plata County.
"It warrants investigation because of the wide spectrum of symptoms
atypical of pertussis," Dr. Sema Mandal said during an interview at
the San Juan Basin Health Department.
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 3 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 3 or 4 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 5 minutes to complete the questionnaire."
[Byline: Dale Rodebaugh]
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