MIDDLEBURY — Vermont Department of Health (DOH) officials are urging schools, daycare centers, businesses and residents to be on guard for a wave of pertussis — popularly known as whooping cough — that is sweeping through Addison and Rutland counties.
As of the most recent reporting period of Nov. 24, the DOH’s Middlebury district office had confirmed 67 cases in Addison County thus far this calendar year, with another eight suspected cases under investigation. Last year at this time, there was only one confirmed case of pertussis in Addison County. Statewide, 443 confirmed cases of the illness have been reported so far this year, compared to 37 at this same time in 2011.
Bottom line — it’s the largest statewide outbreak of the illness in Vermont in decades, according to Moira Cook, director of DOH’s Addison County district.
“We have seen cases in almost every (local) school during the past year,” Cook said on Monday, noting particular spikes recently at Mount Abraham Union High School in Bristol and Robinson Elementary School in Starksboro.
Jeffrey Heath, public health nurse with the DOH, has been following up on each pertussis report. He said pertussis made its way into northern Addison County from neighboring Chittenden County. It took hold earlier in the year in Ferrisburgh and other Addison Northwest schools, then trickled down into the Middlebury area and Addison Central schools. Heath said the illness has now taken hold in the Addison Northeast region, which includes Bristol, Lincoln, Monkton, Starksboro and New Haven.
Pertussis is a contagious respiratory illness caused by a bacteria. It begins as cold symptoms — runny nose, some sneezing and a mild cough. After a week or so, the cough gets progressively worse, to the point where those afflicted can experience coughing spasms to the point of vomiting or losing one’s breath. In some people, pertussis produces a “whooping” sound when coughing.
Heath explained that pertussis is most harmful to babies less than a year old with fragile respiratory systems. Violent coughing spasms associated with the illness have, in some cases, resulted in infant deaths, though none have been recently recorded in Vermont, Cook noted.
“Anyone can get it,” Heath stressed. “But children are certainly most vulnerable.”
With that in mind, Heath and Cook are stressing two things: That people get inoculated against pertussis to avert contracting it; and if they do get it, they need to see a physician who will prescribe the antibiotics necessary for recovery.
The pertussis vaccine can be given to infants at 2, 4 and 8 months; at 12 to 15 months; then at pre-K; and an adult-adolescent dose that is given to children before 7th grade and all adults — especially those working around infants, such as at schools and childcare centers.
Inoculations are usually administered at physicians’ offices but are also available for free at the Middlebury DOH office at 156 South Village Green, suite 102, and at the Open Door Clinic in Middlebury.
“We try not to take people away from their (family physicians), but if there is any reason that you can’t get it from your primary care provider, we would be happy to do that,” Cook said.
The adult-adolescent pertussis vaccine is expected to last the patient the rest of their lives, according to DOH officials. Meanwhile, the DOH recommends that infants and children get their regular pertussis immunizations — a subject that has stirred controversy at the state level. Vermont law requires children to receive pertussis inoculations before entering public schools, with exemptions allowed for families citing religious or philosophical reasons. The Legislature this past session considered removing the philosophical exemption, but ultimately retained it. Some parents have also voiced concern about children potentially suffering debilitating side effects from the vaccine.
Health department officials are obligated to investigate and track every suspected pertussis report they receive. The Middlebury DOH is currently investigating 26 leads.
“We follow up on every rumor we hear,” Heath said. “We are not trying to pry; we are trying to protect fellow community members, especially infants.”
The department recommends that anyone with a confirmed case of pertussis stay out of school or work for five days while taking the antibiotic therapy, after which they will no longer be contagious.
DOH credited local physicians’ offices and schools for being proactive in identifying and treating suspected pertussis patients, and the folks they have been potentially exposing to the malady. People who have been exposed to pertussis patients are sometimes given the antibiotics preemptively, according to Heath.
Wanda Bouvier is school nurse at Mount Abraham Union High School.
“We have see a rise in whooping cough. The numbers have tripled since the beginning of the year,” Bouvier said, noting more than 20 confirmed student cases since the beginning of the school year. She is in contact with the DOH two to three times per week.
Thankfully, the school has not had to cancel classes due to pertussis cases.
Pertussis cases usually run in three- or four-year cycles, according to DOH officials, who expect additional cases to be reported in Vermont next year.
“Typically, this big spike will last two years,” Cook said. “We are at the beginning of year two. We are expecting to be up to our eyeballs in pertussis for another year until it naturally wanes off.”
Reporter John Flowers is at firstname.lastname@example.org.