2/24/12 County makes vaccine free to all

County makes vaccine free to all
Fears pertussis outbreak getting out of hand
By Molly McGowan The Times-News 2/24/12     
Reprinted with permission.

   The Alamance County Health Department announced Thursday that it has lifted restrictions on who can receive the Tdap vaccine. The pertussis medication, which is usually $35, is now free for a limited time, and the department will be holding a communitywide vaccination clinic in March.

   The decision follows a countywide pertussis outbreak that has 82 confirmed, probable, suspected or epidemiologically linked cases of pertussis, commonly known as “whooping cough,” since the middle of last December.

   “Epi-link” cases refer to pertussis cases in which the disease develops in a person who had been in close contact with someone who had a lab-confirmed case. “Probable” defines a case of pertussis in which the patient has not been in close contact with a lab-confirmed case, but has exhibited symptoms for two or more weeks, said Communicable Disease Program Coordinator Ayo White.

   To date, said White, there have been 15 lab-confirmed, 31 epilinked, three probable and three suspect cases in Alamance County. “These are the numbers up to this point,” and are expected to change quickly, she said. White acknowledged that 82 is a high number of pertussis cases and said, “This is more than usual.”

   However, she explained, pertussis is cyclical and an outbreak occurs about every three years. “This is just our time right now,” White said.

   In fact, the area was possibly overdue. Medical Director Dr. Kathleen Shapley-Quinn said, “In the 10 years I’ve worked here, I’ve never had an outbreak (in Alamance County).”

   The outbreak is a big one, hitting five elementary schools, four middle schools, two day cares and three other individuals in the county.

   “They’re not just in the school systems,” White said.

   The 12 schools with confirmed cases of pertussis are: Broadview Middle School, Turrentine Middle School and Eastlawn Elementary School in Burlington; Western Alamance Middle School in Elon; B. Everett Jordan Elementary School, South Graham Elementary School, Alexander Wilson Elementary School and Graham Middle School in Graham; Audrey W. Garrett Elementary School, Hawfields Middle School and Woodlawn Middle School in Mebane; and Haw River Elementary School in Haw River.

   The Health Department has been administering azithromycin, an antibiotic, to confirmed cases and Shapley-Quinn said the department has taken a targeted approach when giving the antibiotic to suspect cases. She said those at the highest risk take precedence, such as those children who have been in close proximity to confirmed cases and have poor immune systems.

   Shapley-Quinn said pertussis symptoms are unique in that the cough is usually a series of five to 15 coughs without a breath between them, followed by a hard time breathing. The deep inhalation of air following the coughing is what makes the “whoop” noise.

   She said pertussis starts out like a regular cold, with either a little fever, sore throat or runny nose for a week, before progressing into the cough, which lasts much longer.

   “It can last for months,” said Shapley-Quinn. “It has historically been called the ‘100-day cough.’”

   Health officials are concentrating their efforts on immunizing as many people as possible, especially those at higher risk. Immunization Program Coordinator Christie Sykes said infants under 12 months, immuno-compromized individuals and pregnant women are considered high risk.

   Sykes said children 11 to 12 years old typically receive the Tdap vaccine, since the state requires the immunization before moving on to the sixth grade. However, she urged adults to take advantage of the free Tdap vaccines, since they didn’t become available to adults until 2005.

   White said, “You may not have the immunities you had as a child since the immunization’s strength wanes over the years. Sykes added that there’s no danger in a patient getting a Tdap if he or she has recently had a plain tetanus shot.

   A free Tdap vaccine is currently being offered on a walkin basis at the Health Department, Monday-Friday, from 8 a.m. to 11 a.m., and again from 1 to 4 p.m. The vaccine will remain free for a “limited period,” Sykes said. “We don’t know how long that’ll go … at least a month.”

   The community-wide Tdap vaccination clinic will be held March 2, from 3 to 7 p.m. at the Mebane Arts and Community Center, located at 633 Corregidor St. in Mebane. For more information on pertussis or the Tdap vaccine, call the Alamance County Health Department at 336-227-0101.