Linn County officials cope with pertussis outbreak, offer free vaccines to students

In response to a sharp statewide increase in pertussis, as well as a countywide outbreak, Linn County Public Health is offering free pertussis boosters to local students age 10 and older.

According to the Iowa Department of Public Health, 1,085 cases of pertussis have been reported in Iowa this year as of Sept. 7. That's more than 4.5 times more than the 232 cases the department recorded in 2011 and more people with pertussis than the last two years combined. Of those 1,085 cases, 178 were tallied in Linn County, by far the largest amount in the state. Cerro Gordo County is second, with 120 cases so far, followed by 118 reported instances of pertussis in Polk County.

As a result, Linn County Public Health is partnering with local middle and high schools to provide as many free TDAP (tetanus, diptheria and pertussis) shots as possible for students.

"A lofty goal would be every single student eligible," said Heather Meador, a nurse with Linn County Public Health. "The best way to prevent whooping cough is through vaccination."

Local school districts have begun distributing notices and forms to parents regarding the vaccination clinics and once Linn County Public Health has received them, the department can order the right amount of doses and schedule the clinics.

"We'd like to have them up and going by next month," Meador said, noting she's already heard back from the Cedar Rapids, Lisbon, Mount Vernon, Alburnett, Central City, College and Marion school districts.

The Mount Vernon Community School District has seen the highest amount of pertussis cases of any Linn County district this year, with 13 infected students identified this school year, just shy of 1 percent of the district's student population. District staff were identified of the most recent positive test result Tuesday.

District Nurse Melissa Hauser and Superintendent Pam Ewell both struggled to pinpoint a reason why the disease has hit the district so hard, especially given that Hauser estimated only five or 10 students have received exemptions for the pertussis shot.

The first student case in Mount Vernon, a high schooler, was identified in late June. Of the students with pertussis this school year, half have been early childhood through first-grade students and the remaining half have been middle schoolers.

Statewide, children ages 10 through 13 are responsible for the largest proportion of confirmed and probable cases of whooping cough this year. The diptheria, tetanus and pertussis (DTP or DTAP) immunization, a five dose series, is one of many required for students to begin school in the state of Iowa, with the last shot scheduled for age 4.

"Over time the immunity to pertussis wanes," Meador said. "So by the time those kids are 9 or 10, they've lost their immunity to pertussis.”

Currently, the TDAP booster is recommended for people age 10 and older but is not mandatory for school entry, something Meador says may change within the next few years.

"You would think that age group would be the most protected because they've all had their first shot," Hauser said. "It just doesn't make sense.”

Whooping cough outbreaks are cyclical, with rises typically occurring every three to five years. The last statewide outbreak was recorded in 2010, when the department of public health observed 705 cases, 102 of which were in Linn County.

"This [outbreak] is just more intense that the previous ones have been," Meador said.

Linn County has seen an eight fold increase in people with pertussis compared to last year, when only 22 cases were recorded. Meador said the uptick began in mid-June and summer activities like barbecues and pool parties, "venues with a lot of people," facilitate the disease's spread.

“A lot of times you don't feel sick.  You feel fine," she said. "They think it's an allergy or they think they just have a summer cough."

Pertussis spreads when someone with the disease coughs and others around that individual inhale the bacteria.

While Meador said the disease wasn't showing up in any specific Linn County populations -- "we've seen it all over," she said -- the department is targeting students because of their proximity to each other.

"They're all back in school together and they spend all that time together and they're in close contact," Meador said. "Kids are so social and they're together all the time."

The disease has a 21 day incubation period and students must stay home from school for four to five days while they await test results or complete a series of the antibiotic treatment.

"That's been the hardest part," Hauser said. "Making sure the students stay home, that takes coordination with the doctor's office, Linn County and the public schools."