Winnipeg Free Press - PRINT EDITION

Whooping cough case fatal

Province offering free vaccinations to adults to try to keep disease in check

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As whooping cough wheezes back to life, the province is pushing free jabs to boost vaccination rates against the disease.

In a press release issued Thursday that could send tens of thousands of Manitobans scrambling for an appointment with their doctor, Manitoba Health advised all adults who have regular contact with children be vaccinated against the bacterial infection pertussis, better known as whooping cough.

This is especially true for parents or caregivers of babies under two months old.

Thirteen cases of whooping cough have been confirmed in Manitoba in 2012. One patient, a baby under a year old, died from the disease.

While the total number of cases isn't unusually high -- Manitoba averaged 37 cases of whooping cough annually over the last decade -- it's the first time in five years the province has seen a fatal case.

"That, for us, is important," said Dr. Richard Rusk, Manitoba Health's medical officer.

"This is supposed to be a conquered disease, but it's not anymore. Clearly we need to promote the recognition that it is the community that actually protects the children."

And that protection has been slipping. In Manitoba, children are vaccinated against pertussis with a trio of shots when they are two, four and six months of age, with boosters later on. But immunity rates begin sliding in teenagers, as the vaccination protection appears to wear off and adults pass on boosters.

Only about 68 per cent of Manitobans have immunity to whooping cough.

That's far below the rate medical experts consider ideal, and far below the roughly 92 to 94 per cent needed for what is called "herd immunity," or the point where a virus or bacteria has trouble gaining a toehold in a community.

In the United States, Rusk said, some communities have seen notable whooping cough outbreaks after immunity slipped even to 80 per cent. And the most vulnerable victims aren't the adults who are unaware their immunity has worn off: It's the children they come into contact with.

"We've got this gap where infants are quite susceptible," Rusk said.

"There's a certain degree of passive immunity (in infants) from their mother -- but when that wanes, you have this gap because vaccine is only truly effective after having all three shots. And if you've got pertussis in the community, and you're going and visiting friends with kids, you see how it can spread."

Much ink has been spilled in recent years about whooping cough's recent revival in North America.

The bacteria is highly contagious and can be spread through coughing or sharing food or drinks. Communities in British Columbia, New Brunswick and New York are among the spots struggling to contain an outbreak.

The vaccine, which made its debut for children in 1997, is more effective than the one most Manitoban adults would have received when they were young.

Rusk said while Manitobans don't have to race to get the jab, he did recommend they speak to a primary care physician at their next checkup.

The pertussis vaccine is combined with a tetanus booster.

Other than that, Rusk advises keeping an eye on cold symptoms that last longer than a week, or come with a pronounced cough, and always practise good handwashing and hygiene techniques.

News of the advisory did raise questions in the child-care community on Thursday. Child-care providers in Manitoba are not required to follow a specific vaccination regime, Manitoba Child Care Association executive director Pat Wege noted, so the news could see a rush of child-care workers and other caregivers looking to determine their vaccination status.

"Things come up when you work in a child-care environment," she said.

"We do appreciate the directive from the province that lets people know what to watch for. Caregivers are already skilled in terms of the prevention of infection, such as with handwashing, so they will just be more mindful."

melissa.martin@freepress.mb.ca

Republished from the Winnipeg Free Press print edition August 3, 2012 A4

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