California’s largest outbreak of whooping cough in 50 years has school administrators working on protocols — when to send or keep students home — to stop the spread of the disease in schools, said a nurse at Everett Middle School.
“This disease is very serious,” said Kathy Ward. “We are definitely calling this an epidemic, and are working closely with the Department of Public Health.”
The state declared an epidemic after the number of cases spiked in June. There have been more than 50 cases in San Francisco this year, according to an August report from the California Department of Public Health. A memo posted on the San Francisco Unified School District’s website states that there have been four times as many cases this year as last.
Pertussis, the scientific name for whooping cough, is a respiratory disease that mimics symptoms of a common cold or flu and is highly contagious. According to the Centers for Disease Control and Prevention, the bacteria is spread the same way as a cold, by coughing and sneezing — but unlike a cold, the disease can lead to death if left untreated. Those cases are rare: Out of the more than 3,000 cases reported statewide this year, only eight deaths — all of babies under three months old — have been recorded, according to a pertussis report from the California Department of Public Health.
Though the disease has many worried, Dr. Jaime Ruiz, chief of pediatrics at Mission Neighborhood Health Center, is not.
“The patients at this health center and in this community seem to be very well-vaccinated,” Ruiz said. The immunization rate for Latino children in the state is about 70 percent, Ruiz said, while the rate for patients at the Mission Neighborhood Health Center is about 94 percent. “We routinely update their vaccines.”
Staff members from the Mission Neighborhood Health Center hand out information and immunization schedules a couple of times a week at neighborhood schools, local health fairs and organizations like Head Start, to educate parents.
The California Immunization School Law requires that children be up-to-date on their immunizations before starting school. Ward said four doses of pertussis vaccine need to be administered between the ages of 4 and 6.
If the series is completed by age 7, a pertussis booster — an additional injection to ensure the initial vaccine is effective — is not required, because the vaccine should last 10 to 15 years. However, because of the outbreak, a booster shot is highly recommended at 10 years, health officials said.
Children can be required to stay home from school if they are not up-to-date on vaccinations when there is a high risk of contracting a communicable disease like pertussis, according to a memo from the Department of Public Health.
“Most of the parents have been coming in on their own,” Ruiz said. “But there are still some that don’t have their vaccines, and those are the ones we want to catch.”
Parents started questioning vaccinations in the late 1990s, when Andrew Wakefield, a British researcher, linked the measles, mumps and rubella vaccine (MMR) to a spike in autism. Wakefield’s research caused an uproar and led many to believe that all vaccines cause autism. “It’s been disproved,” Ruiz said of the link between the MMR vaccine and autism.
Because of the scare, Ruiz said, parents stopped vaccinating their children, resulting in outbreaks of vaccine-preventable diseases like mumps, measles and now pertussis.
Ruiz said babies and infants are the most susceptible because of their weak immune systems. An infant can get very sick, and without care the immune system is overwhelmed, eventually leading to death. Symptoms include nasal congestion and a distinct cough that sounds like a hiccup, with the patient gasping for air.
The disease is not painful. Ruiz said he has heard that the Chinese name for pertussis is “the cough of a hundred days,” because sufferers cough constantly for a long period of time.
Keeping up with routine health care and immunizations is difficult for many in the Latino community, but there are ways to keep children healthy, Ruiz said. Children in the state of California are covered by a program called Vaccines for Children (VFC).
Through VFC, parents can register their children to get vaccines, physicals and other exams. In San Francisco County, no documentation is required, Ruiz said. Vaccines are free for children.