HEALTH ALERTS

For Immediate Release

Thursday, May 29, 1997

Contact: Joan Baumbach, MD, MPH District Health Officer (505) 524-6140

Luis Castellanos, MD, PhD Epidemiologist (505) 646-7966; 1-800-784-0394 Pager 1-800-999-6710, ID 990-8862

Within one week, the New Mexico Department of Health in Las Cruces has received confirmation of a second infant with whooping cough (pertussis). A 6-month old infant who was reported being current with immunizations was the first case. The second child confirmed on Tuesday was a 3-month old infant also reported being current with all immunizations. Both children had to be hospitalized for several days. IT IS IMPORTANT FOR THE PUBLIC TO UNDERSTAND THAT CHILDREN ARE CONSIDERED INCOMPLETELY PROTECTED UNTIL THEY RECEIVE AT LEAST 3 DOSES OF VACCINE BY 6 MONTHS OF AGE AND 5 DOSES BY 4 YEARS OF AGE. THEREFORE, ANY CHILD WHO HAS NOT COMPLETED THIS SCHEDULE SHOULD IMMEDIATELY CONTACT A MEDICAL PROVIDER.

Early diagnosis and treatment of individuals with this disease is extremely important, particularly in small children.

To prevent the spread of this disease, the New Mexico Department of Health in Las Cruces has initiated active disease control efforts. As this investigation proceeds, it is recommended that all medical care providers have a high index of suspicion when evaluating infants at high risk.

Pertussis can begin with a runny nose, mild sore throat and other symptoms suggestive of a common cold. Persons with the disease usually develop a cough after the first week, and they can have coughing spasms (whoop) that gives the disease its common name. Although infants with pertussis-related complications may require hospitalization, most patients will develop only a milder illness. Some infants with mild disease can carry and spread the disease if they are not treated properly.

We are alerting all medical care providers to:

1-Consider pertussis infection among infants with signs and symptoms suggestive of the disease, particularly if children are incompletely protected. Any person with history of undiagnosed coughing for 1 or 2 weeks, accompanied by paroxisms, whoop, and/or vomiting should also be suspected of pertussis infection.

2-Contact the New Mexico Department of Health in Las Cruces (505-524-6003, 505-646-7966 or 1-800-784-0394) to report any individual with a suspicious pertussis infection, even if the laboratory confirmation is not available.

3-Contact the New Mexico Department of Health in Las Cruces (505-524-6003, 505-646-7966 or 1-800-784-0394) if you need any support for laboratory confirmation of pertussis infection.

Proper antibiotic antibiotic treatment can prevent persons with pertussis from spreading it to others. Antibiotic treatment also protects individuals who come into close contact with persons who have pertussis from contracting the disease.

Pertussis is present in all regions of the United States, and over 7,500 cases were reported nationwide in 1996. The reported incidence of the disease in New Mexico is usually higher than the national incidence. In 1996, over 60 cases of this illness were reported in New Mexico, although only 2 were from residents of Doņa Ana County. Since not all cases of the disease are laboratory-confirmed, the actual number of cases in the state may be greater than the cases reported to state officials.

The Department of Health offers the public the following recommendations for dealing with pertussis:

1-Infants should receive their first pertussis vaccine (the DTP vaccine) at two months of age, then followed with booster shots at 4 and 6 months of age. Children should complete the entire series of 5 DTP shots between ages 4 and 6 years.
2-Anyone who has been in contact with a person with suspected or confirmed pertussis should seek medical advice from their private health care practitioner or local health office. Anyone with an undiagnosed cough lasting longer than two weeks without another diagnosis should seek medical attention.
3-Anyone who has been diagnosed with pertussis, either by clinical or laboratory means, should stay home and avoid contact with persons outside their family for five days after beginning antibiotic therapy.
4-Persons being treated for pertussis should make sure that they complete the full 14 days of therapy to prevent relapse and further spread of the disease.

The pertussis vaccine is credited with drastically reducing the number of cases of pertussis and the number of deaths caused by this disease in the United States. However, the protection provided by the vaccine decreases with age, so persons who received the vaccine as children can still contract pertussis as adults (although generally in a milder form). "Vaccination is still the most important step parents can take to protect their children from pertussis," said Dr. Joan Baumbach, District III Health Officer with the Department of Health. The vaccine is recommended for all children unless they have a specific medical reasons to avoid the vaccine.

Persons older than seven years are more likely to have side effects from the vaccine. Under current recommendations, these individuals should not receive the vaccine, even if they were not vaccinated when they were younger.

If you have any questions, please contact your health care provider. or call Dr. Joan Baumbach, 524-6144, Dr. Luis Castellanos or Dr. Luis Escobedo, 646-7966 or 1-800-784-0394.