Whooping Cough in Contra Costa County

1
Whooping Cough in Contra Costa County

• Erika Jenssen, MPH
• Immunization Coordinator

2
Timeline of Outbreak

• April 2008 Contra Costa Public Health is
  notified of case of pertussis at school with high
  number of personal belief exemptions

3
Outbreak continues through April

• School no cough policy and antibiotic
  prophylaxis for certain classrooms
• More cases identified primarily in kindergarten

4
Questions, Questions

• What is whooping cough (pertussis)?
• Who is most at risk? Is it serious?
• Who has been exposed?
• Who should be tested? What do the results mean?
• What is the purpose of antibiotics?
• How do I do a nasal swab? Where do I send it?
• What is the prophylaxis/treatment protocol?

5
Communication

• With school including staff and teachers phone,
  email, fax, meetings
• With parents school newsletter, parent meeting,
  home visits
• With health care providers special delivery of
  lab supplies and instructions

6
School Closure!

• 16 cases with no end in sight
• Decision to close school for one day - Friday,
  May 9th
• Require everyone returning to present antibiotic
  prescription or stay at home for 3
  weeks

7
More communication

• On site at the school for antibiotic dispensing
  and school closure decision
• Phone tree, email and written notice out to
  parents immediately notice posted on school
  doors
• Ongoing contact with school administrators
• Personal calls from families at the school

8
More questions

• What authority does the Health Department have?
• Why do vaccinated kids need to take antibiotics?
• Why do vaccinated kids get whooping cough?
• What if my child already had whooping cough or
  has been coughing for x number of days?
• Where can I get an antibiotic prescription?
• What do you mean stay home for 3 weeks?
• Does everyone in the family need to be tested and
  on antibiotics?
• Isnt it better to get the natural disease?
• What about giving probiotics with the
  antibiotics?
• What natural remedies can I use for the cough?
• How do I interpret the PCR?
• Can I use other lab tests? Whats the gold
  standard?
• Do I need to let other people that I have been in
  contact with know?
• Why did the Health Department do a press release
  about our school?
• Why doesnt the school make people get
  vaccinated?
• How many vaccinated kids have gotten whooping
  cough?

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9
Media Attention

• Media advisory sent out Thursday afternoon to
  announce outbreak and school closure (didnt
  mention name of school)
• Friday am press conference planned school
  invited to participate

10
Crafting of messages

• The outbreak could have been prevented if more
  children were vaccinated
• California school law allows for personal
  beliefs exemption and school complied with the
  law
• Although called personal, the decision NOT to
  vaccinate affects the whole community

11
Video
12
A News Story

• Friday press conference covered by major news
  outlets in Bay Area
• Ongoing updates of outbreak status posted on
  Public Health website and sent to media
• Blogs by parents of children at the school

13
Outbreak wraps up

• Symptom screening at school initially and after 3
  weeks
• No cough policy until the end of the school
  year
• No new cases at school after closure and
  antibiotic regimen

14
Continued attention

• Editorials and opinion columns
• Regular Healthy Outlook column
• Letters to the editor
• Educational example at presentations

15
Impact at school

• Back to school night presentation
• Two parent evenings about vaccines
• Published Health and Wellness Guide

16
Acknowledgements

• Contra Costa Public Health Communicable Disease
  staff
• Susan Farley, PHN
• CDPH Immunization Branch staff
• Dr. Rob Schechter
• East Bay Waldorf School staff