Thursday, Aug. 8, 2002 | 11:12 a.m.
An outbreak of whooping cough has struck 14 people in Clark County this year, up from only six cases last year and three cases in 2000.
"A lot of people haven't even seen a case of whooping cough because of the immunizations that we have today," said Sally Jost, head nurse for the Clark County School District. "We've heard about the symptoms, but there aren't a lot of people who can say they've seen a case.
"This is pretty unusual."
The Clark County Health District has alerted area doctors, hospitals and schools about the outbreak of the disease that can be deadly to infants who have not been immunized.
Whooping cough, or pertussis, is a contagious respiratory disease caused by bacteria and usually identified by uncontrolled "whooping" coughing fits.
"Although the disease may be mild in older children and adults, infants may experience complications such as pneumonia and inflammation of the brain," said Dr. Donald Kwalick, chief health officer for the health district. "In rare cases pertussis can cause death, especially in children less than one year of age."
June had the greatest number of reported pertussis cases, with nine. Of the 14 confirmed cases, eight are infants, five of whom were hospitalized. None of the 14 cases has been fatal, and only one infant remains hospitalized at Sunrise Medical Center.
Dr. Larry Satkowiak, head of University Medical Center Pediatric Emergency Room, can only remember seeing three or four cases in the last 10 years at UMC.
"It's something to be concerned about, but if children are immunized there shouldn't be a problem," Satkowiak said. "The immunization wears off as people age, but it isn't as severe in adolescents and adults."
The incubation period of pertussis is commonly seven to 10 days, with early symptoms including a runny nose, sneezing, low-grade fever and cough. As the disease worsens the coughing increases and may cause vomiting or may cause the lips to turn blue from lack of oxygen.
Antibiotics can be used to cure the disease, but the illness is best treated through prevention with the DTP (diphtheria, tetanus and pertussis) vaccine generally administered to infants 2, 4, 6 and 12 months of age and again at 4 years of age.
Children under the age of 18 can get free DTP vaccinations at the main health district office at 625 Shadow Lane. At least three or four doses are necessary to protect a child from the disease, health district spokeswoman Jennifer Sizemore said.
"There was a recent national shortage of the vaccine, but it didn't affect Las Vegas," Sizemore said. "That's not the cause."
The health district is investigating the cases, but have not determined any trends in how the disease is spreading, Sizemore said.
"We know some of the cases have spread within family groups," Sizemore said. "We are really emphasizing that if an adult has been ill with a prolonged cough they should limit their contact with infants or get checked out.
"The big concern is infants that have not yet been immunized."
With the first day of school scheduled for Aug. 26 and year-round schools already in session, the school district is taking precautions, Jost said.
"We e-mailed the information out to the district's nurses, and they will be talking to teachers and administrators to heighten awareness," Jost said. "Whenever we have a child that appears to be ill we minimize their contact with other children, and get them the treatment they need."
The school district requires all students to be immunized before they register for classes, with the exception of two cases -- religious or medical conflicts.
"The parents are the first line of defense, and we hope that they won't send their children to school if they're sick, but that's not always possible," Jost said.
The frequency of pertussis has declined since it was first described in the 16th century, and the organism was first isolated in 1906, according to Centers for Disease Control and Prevention officials.
In the 20th century pertussis has been one of the most common childhood diseases and a major cause of childhood mortality in the United States. In the 1940s more than 200,000 cases of pertussis were reported annually. Since widespread use of the vaccine began, incidence has decreased more than 98 percent to an average of about 4,400 cases per year since 1980.
Pertussis remains a major health problem among unimmunized children around the world, with an estimated 300,000 deaths per year due to the disease.
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