Southern Health grapples with decreased immunization rate in whooping cough fight

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This article was published 28/06/2023 (855 days ago), so information in it may no longer be current.

As Southern Health officials strive to get children in the region vaccinated for whooping cough — amid an outbreak of the potentially deadly, highly contagious bacterial disease — leadership hopes they can stop it from reaching the rest of the province, too.

“Just because we haven’t seen spread to areas like Interlake-Eastern or Prairie Mountain or Northern Health, yet, doesn’t mean that we might not see that as the outbreak evolves,” chief medical officer of health Dr. Davinder Singh said Wednesday.

Public health is the primary immunizer for early childhood immunizations outside of Winnipeg, and there was a decrease in access during the recent pandemic as resources were redirected towards the COVID-19 response, Singh said.

“We did, unfortunately, see decreases in immunization rates for our early childhood immunizations in all of our regions throughout the province, and most significantly in all of our rural regions.”

On Monday, the province declared a pertussis (whooping cough) outbreak in Southern Health, where 152 of the 154 cases in Manitoba have been reported since January.

Southern Health covers 27,025 square kilometres and more than 216,000 residents, including the cities of Portage la Prairie, Steinbach, Morden and Winkler.

“There were significant decreases in immunization in those other regions,” Singh said. “It’s just that they do have still a higher level than Southern Health residents had.

“I hope that that will be protective to stop transmission chains, but I can’t say for sure that it won’t spread to other areas.”

The chief medical officer said he’s aware of additional cases in Southern Health, but didn’t yet have the data to confirm it.

Most (110) cases involved children under the age of 10, including two who were admitted to pediatric intensive care. There were 24 cases of pertussis involving 10- to 19-year-olds, and 20 adults.

Singh said the southern parts of the region west of the Red River have reported most of the cases of the respiratory infection spread through the air.

It’s too soon to say how much vaccine hesitancy associated with the socially conservative area or issues around immunization availability have driven the outbreak, officials said.

“It’s difficult to say for sure,” Singh said. “I think a significant contributor is that, overall, there are decreased immunization rates in residents and children in Southern Health compared to other regions.”

Public health is trying to break the chain of transmission by linking people to immunizations.

Two weeks ago, letters were send to families and parents and guardians of all local children born in 2019, 2020 and 2021, who are overdue for any of their routine immunizations.

“I am concerned about those vulnerable children under one year of age, and especially those under six months of age or under two months of age, because the increased risk for severe outcomes does increase quite dramatically as you get younger and younger,” Singh said Wednesday.

“I am thankful that there haven’t been any deaths so far, but we know that that is a potential severe outcome that can occur from pertussis infections.”

Public health is tailoring its immunization efforts to each specific community, Singh said.

For example, in the Boundary Trails Health Centre area (Morden and Winkler), hours for some of the clinics have been extended, public health offices are running lists to see who’s overdue for immunizations and directly contacting families, and checking to see if “there’s any barriers that might exist.”

The last time there was a whooping cough outbreak of this size in the province was 1998, before electronic immunization reports were kept.

The worst in recent memory was in 1994. Whereas there are roughly 11 whooping cough cases per 100,000 Manitoba residents in the current outbreak, in 1994, there were five times as many.

“It was a very, very large outbreak and I think they saw cases in every area of the province at that time,” Singh said.

“The spread of infectious diseases and development of outbreaks really only takes a small introduction of a number of cases into an under-immunized population for something that’s vaccine preventable to start an outbreak.”

carol.sanders@freepress.mb.ca