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Midwest town sees return of old disease
Scientific American ^ | November 22, 2006 | Deborah Cohen

Posted on 11/24/2006 10:04:55 PM PST by neverdem

CHICAGO (Reuters) - For the past two weeks, high school nurse Colleen Kahler has been on high alert.

Her office, which typically treats routine ailments such as sore throats, stomach aches and pulled muscles, has been transformed into a screening center for an unlikely disease with a name that recalls a bygone era -- whooping cough.

"We became a triage unit," says Kahler, health services coordinator at New Trier High School in Winnetka, Illinois, a tony suburb of Chicago.

"The phones were literally ringing off the hook," she said. "We were fielding questions from parents, physicians and students."

Health experts said the New Trier outbreak underscores how whooping cough, a highly contagious respiratory infection, remains a public health threat in the United States. According to the Centers for Disease Control and Prevention, there were more than 25,600 reported cases in 2005; the true number may top 1 million annually.

It killed 13 children, mostly infants, in 2003.

Before immunizations became widespread, an average of 147,000 people in the United States developed whooping cough every year and 9,000 died.

Whooping cough is common in countries where children do not receive vaccinations -- 294,000 people worldwide died of the illness in 2002, according to the World Health Organization.

It is making a resurgence in other developed countries, such as Britain. Germany began vaccinating teens against pertussis in 2000.

An upswing of reported cases in the past decade is a source of debate among health professionals, who attribute it both to waning immunity in teenagers and adults and improved detection. Neither the vaccine, nor infection with the bacteria itself, offer lifelong protection.

Beginning at two months of age, babies get vaccinated against whooping cough, also known as pertussis, as part of an early childhood immunization series that includes diphtheria and tetanus.

Until last year, with the approval of a new type of vaccine for people aged 11 to 64, adolescents only got a booster shot for diphtheria and tetanus because the vaccine used in recent years was not approved for people over the age of 7 due to concern about possible side effects.

TRACKING AN OUTBREAK

New Trier had 26 confirmed cases of pertussis by November 16, or one third of all those reported in suburban Cook County. The school's first case was detected in late August when students returned from summer break. There have also been reports of sporadic cases at other high schools in the area.

Since early November, New Trier has been operating under directives from local health authorities to treat the situation as an outbreak.

"If your child has a cough, please do not send him or her to school," the local health department said in a letter to New Trier parents.

New Trier has been trying to limit potential spread to other schools by canceling some athletic and extra-curricular events, circulating fact sheets, letters and e-mails, and keeping a close watch on students, faculty and staff for signs of the disease.

"We don't want to alarm everyone, so it's a big balancing act," said Dr. Catherine Counard, assistant medical director for communicable disease control at the Cook County Department of Public Health. "Whooping cough is a serious disease and we need to get this under control."

Whooping cough is tricky to diagnose because early symptoms are similar to other respiratory illnesses such as the common cold and bronchitis.

One telltale sign is a persistent dry cough. If detected early, the disease responds to antibiotics, but it is often diagnosed late and must be left to run its course.

Rarely life-threatening in teens or adults, small children are at risk for broken ribs, pneumonia, and sometimes death. They typically get the disease from adults, making containment of an outbreak on the scale of New Trier's critical.

PRECAUTIONARY MEASURES

CDC now recommends that adolescents and adults get the new tetanus-diphtheria-pertussis booster instead of the older vaccine that included only tetanus and diphtheria. At New Trier, most of the cases were among older students who had not received the new shot.

"We now know that immunity to whooping cough wears off as we age," said Dr. Susan Rehm, medical director at the National Foundation for Infectious Diseases. "The nice news is that this is preventable through vaccination."

As New Trier battles its outbreak, there have been reports of cases of whooping cough at Children's Hospital in Boston and a high school in Palo Alto, California.

Trying to get a handle on the health status of more than 4,000 students spread over two school campuses has been no small feat, New Trier's Kahler recalled. Anyone with a sustained cough -- teachers and staff included -- has been sent home pending clearance from a doctor.

Kahler had to initially double her staff to six nurses and add a secretary just to keep up with extra paperwork, lab results, student whereabouts, community outreach and the endless stream of phone calls.

Preventive measures at the school have ranged from subtle to humorous. A large container of Purell hand sanitizer and Kleenex is now a staple in every classroom. Students were shown a film entitled "How to Do It In Your Sleeve," which offers a primer on minimizing the spread of germs when coughing.

But despite the school's best efforts, the outbreak has not been easy on the local community. Many pediatricians were not ready for the onslaught of requests for pertussis vaccine and parents have had difficulty seeking alternative sources.

"The numbers are much less now because the kids are getting cleared and getting treatment," said school superintendent Linda Yonke. "I hope we're through the worst."


TOPICS: Culture/Society; Government; News/Current Events
KEYWORDS: commoninmexico; health; medicine; newtrierhighschool; pertussis; whoopingcough
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1 posted on 11/24/2006 10:04:57 PM PST by neverdem
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To: neverdem
I used to get whooping cough as a kid in Naperville.

Now I'm an old guy getting hangovers in St. Louis.

2 posted on 11/24/2006 10:06:20 PM PST by demsux
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Comment #3 Removed by Moderator

To: John Williams

Actually, this problem is going on elsewhere and illegals are probably the cause.


4 posted on 11/24/2006 10:24:07 PM PST by TheLion
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To: neverdem

Massachusetts hospitals have had cases among their staff recently: Worcester = 30 in Sept., Childrens' Hospital in Boston = 15 in Oct./Nov.

The Worcester cases have been tracked back to a surgeon returned from active duty with the reserves. The Boston cases started with a patient.




5 posted on 11/24/2006 10:24:57 PM PST by LibFreeOrDie (L'Chaim!)
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To: John Williams

http://fastfacts.census.gov/servlet/CWSFacts?geo_id=05000US17031&_sse=on


6 posted on 11/24/2006 10:27:22 PM PST by Brad’s Gramma (Get right with God....eternity is a long time.....)
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To: neverdem

The problem rises from illegal immigration. The US wiped out most of these diseases and became very complacent about vacinating against them in the last 20 years or so. A lot of kids are going to suffer.


7 posted on 11/24/2006 10:35:17 PM PST by TheLion
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To: TheLion; John Williams
Actually, this problem is going on elsewhere and illegals are probably the cause.

That's not the whole story as many Luddites have been successful in generating fear towards childhood vaccinations.

8 posted on 11/24/2006 10:54:16 PM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: neverdem
yes! the area i used to live in had a huge herd of hippies that lived in the hills. (i could make a poem outta that i bet...) anyway, they were all convinced getting your kids shots for measles, mumps, rubella and whooping cough would either kill them or make them autistic. :roll eyes:
9 posted on 11/24/2006 11:35:13 PM PST by ferri (Be Politically Incorrect: Support the Constitution!)
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To: John Williams

We are talking about the most exclusive school district in Illinois!
The only illegals in this school district are the lawn help.
It's thee Upper middle class community north of Chicago.
This is very strange.

If this came from illegals I doubt it. There would be contageon in Pilsen , Humboldt Park or the West side

My theory is the soccer moms buy that trendy organic food
which is laced with fecal matter. Well, just kidding.

Could be these old time diseses are making a come back. It's a scary thought if they've become super bugs. Super viral and bacterial mutations. Let's pray this is only incidental.


10 posted on 11/25/2006 12:13:16 AM PST by ChiMark
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To: ChiMark
We are talking about the most exclusive school district in Illinois! The only illegals in this school district are the lawn help. It's thee Upper middle class community north of Chicago. This is very strange.

Gardeners, janitors, etc. Probably illegals leaving their mark.

11 posted on 11/25/2006 2:52:17 AM PST by raybbr (You think it's bad now - wait till the anchor babies start to vote.)
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To: ferri

My question is, why is there a "Vaccine Compensation Fund" if vaccines are so safe? The fund was set up to help families whos children had an adverse reaction to a vaccination. The hard part is proving it was a vaccination that caused harm to your child.


12 posted on 11/25/2006 5:01:39 AM PST by 84navy88 (proudly served under President Reagan)
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To: demsux

Ditto that. I had it as an infant. One of the few memories I can recall from my very early years is that bout of whooping cough.


13 posted on 11/25/2006 5:34:43 AM PST by Wonder Warthog (The Hog of Steel-NRA)
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To: ChiMark

How about the Mexicans fixing the kid's lunches at Wendy's?Or the one's cleaning their houses? Or the ones shopping at the same grocery stores?


14 posted on 11/25/2006 6:16:41 AM PST by nitzy (It is never right to do the wrong thing for political expedience.)
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To: raybbr
We are talking about the most exclusive school district in Illinois! The only illegals in this school district are the lawn help. It's thee Upper middle class community north of Chicago. This is very strange.

Gardeners, janitors, etc. Probably illegals leaving their mark.

---
Very, very doubtful. There are places in the Chicago area where there are lots of illegals living. Winnetka is NOT one of them. Blaming this on gardeners, well why aren't the neighborhoods that the gardeners spend the other 128 hours of their week having outbreaks? They sure aren't living in Winnetka.

Actually the organic food theory someone else advanced above is more likely.
15 posted on 11/25/2006 6:29:12 AM PST by Cheburashka (World's only Spatula City certified spatula repair and maintenance specialist!!!)
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To: 84navy88
My question is, why is there a "Vaccine Compensation Fund" if vaccines are so safe?
---
Lawyers.
16 posted on 11/25/2006 6:30:28 AM PST by Cheburashka (World's only Spatula City certified spatula repair and maintenance specialist!!!)
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To: nitzy
How about the Mexicans fixing the kid's lunches at Wendy's?Or the one's cleaning their houses? Or the ones shopping at the same grocery stores?
---
If contact with Mexicans is the source of infection, New Trier would be the LAST high school it would show up in in the Chicago area. Look to the Chicago Public Schools first.
17 posted on 11/25/2006 6:38:39 AM PST by Cheburashka (World's only Spatula City certified spatula repair and maintenance specialist!!!)
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To: 84navy88

There are risks to vaccines. The issue is whether the benefits outweigh the risks.


18 posted on 11/25/2006 6:45:19 AM PST by luckystarmom
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To: Cheburashka
-- Very, very doubtful. There are places in the Chicago area where there are lots of illegals living. Winnetka is NOT one of them. Blaming this on gardeners, well why aren't the neighborhoods that the gardeners spend the other 128 hours of their week having outbreaks? They sure aren't living in Winnetka.

I didn't say they lived there. It doesn't take living somewhere to spread germs.

Actually the organic food theory someone else advanced above is more likely.

It might be. I don't know that pertussis can be transmitted through food.

19 posted on 11/25/2006 7:23:59 AM PST by raybbr (You think it's bad now - wait till the anchor babies start to vote.)
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To: raybbr

As I responded to someone else, if contact with Mexicans is the source of infection, New Trier would be the LAST high school it would show up in in the Chicago area. Look to the Chicago Public Schools first.


20 posted on 11/25/2006 10:20:53 AM PST by Cheburashka (World's only Spatula City certified spatula repair and maintenance specialist!!!)
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