TAMPA — An outbreak of whooping cough in Hillsborough County has struck 10 schools—nine public and one private. Now health officials worry that summer camps, outings and family vacations may allow the illness, also known as pertussis, to spread even more widely.
"Kids will be fanning out to various churches, camps and community centers, which increases the opportunity to spread pertussis and the number of people who will be exposed," said Warren McDougle, epidemiology program manager for the Hillsborough County Health Department. "The school year ending isn't necessarily going to bring us relief from this outbreak."
Pertussis or whooping cough, as it is commonly known, is a highly contagious bacterial infection that causes coldlike symptoms and uncontrollable, violent coughing that can go on for weeks, even months. It is most dangerous — even potentially fatal — to infants.
So far this year, Hillsborough County has seen about 40 cases. Last year Hillsborough reported just two cases between January and June.
The Florida Department of Health issued a reminder about the importance of vaccination late in April when whooping cough cases spiked statewide. But cases are not up in all counties — Pinellas has had just two this year.
Although children must be vaccinated against the disease to enter school, infection rates have been on the rise nationally for the past few years. Experts say that may be largely because many adults do not get booster shots, recommended every 10 years.
Pertussis symptoms may not seem so bad in older children and adults, especially at first, so people might not even know they are a danger to others.
Also, some parents are refusing vaccines for their children — making them more vulnerable if they come into contact with the bacteria. At least seven of the Hillsborough cases are linked with vaccine refusal.
It's also possible that the vaccine schedule might need to be adjusted, or that the vaccine might need to be reformulated, McDougle said.
Dr. Charurut Somboonwit, associate professor of infectious diseases at USF Health, has been called in by the health department to help with some cases. She shares the concern about adults not getting boosters.
"They may not know that immunity wanes, and they haven't had the vaccine since childhood,'' she said.
The vaccine is given in five stages: at two months, four months and six months; between 15 and 18 months and before a child begins school, usually between 4 and 6 years of age.
Hillsborough County and other jurisdictions require children to receive the pertussis vaccine again before entering seventh grade, as part of the Tdap combination that protects against tetanus, diphtheria and pertussis. Though Florida law does not require a seventh-grade shot, health officials recommend it.
Since April, the affected Hillsborough schools have sent hundreds of letters and emails to parents informing them when a case was detected at their child's school. The most recent letters went out Thursday after six cases of whooping cough were identified at Wilson Middle School.
All those children were current on their immunizations, though some of them, as sixth-graders, hadn't yet had their seventh-grade shot.
In the letters to parents, officials are urging them to consider antibiotics for their children, which have been shown to prevent the disease or at least shorten its duration in those who have been exposed. Antibiotics can also make a child who is infected less contagious to others.
But some parents aren't heeding the warnings. At least two children who developed the disease did not receive antibiotics after they had been recommended, McDougle said.
"I know that some people just don't like to take medications or get vaccines, but it's for the good of the community, to protect others not just to protect you,'' Somboonwit said.
"This disease can be fatal in young children who get it and yet it is largely preventable."
Shots and drugs aren't the only means of prevention, she said.
"It's very important that everyone practices coughing etiquette. Cough and sneeze into your elbow. Wash your hands frequently. Doing that will help a lot in preventing the spread of infectious diseases, not just pertussis."
Irene Maher can be reached at firstname.lastname@example.org.