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County health, school officials learn from pertussis outbreak

The Alamance-Burlington School System has an exceptionally high vaccination rate among its students, local health department representatives told school board members this week.

That was a major part of the discussion when Barry Bass, the department’s director, and Dr. Kathleen Shapley-Quinn, its medical director, talked with school board members and answered questions about a pertussis outbreak during a work session held Monday.

Bass called the outbreak “an extraordinary situation” that began in December and has grown to include more than 103 cases that are either confirmed or probable, with an almost equal number falling into each category.

“It certainly has been a learning curve,” he said. But he and Shapley-Quinn praised the school system, and in particular public information officer Jenny Faulkner, for effectively working with the health department. The school system has worked with the health department to identity “close contacts” of students with confirmed or reportable cases in order to notify families.

Pertussis, or whooping cough, is a bacterial infection of the respiratory tract that can last for many weeks. Symptoms include a runny nose, low fevers, coughing fits and vomiting.

Bass said the system has a “really good vaccination rate,” which “raises questions about the vaccine itself” and its effectiveness in preventing the disease.  He and Shapley-Quinn said it’s likely the Centers for Disease Control will study the situation to examine those questions.

 

SHAPLEY-QUINN SAID there’s no instance of a child who had not been vaccinated getting pertussis, though the health department is waiting to receive paperwork to confirm for certain one student was up to date on the shots.

In accordance with guidance from the Centers for Disease Control, the local health department has shifted its strategy since the outbreak began.

After pertussis was found at B. Everett Jordan Elementary School, Shapley-Quinn said, “We gave out 700 courses of preventive antibiotics in that school alone.”

With approval from the CDC, the health department began shifting its approach in an effort to balance disease prevention and overuse of antibiotics, which can weaken resistance of the body’s immune system. Now, families of students considered close contacts of those with confirmed or probable cases of pertussis get a letter that says “If you have a cough, see your doctor” instead of automatically being offered the antibiotics.

The health department retained the more aggressive approach in situations where family members or others are at higher-than-normal risk of getting the disease.

The health department has given preventive antibiotics to about 1,400 people, including the 700 in the B. Everett Jordan Elementary situation. That’s about 1 percent of Alamance County’s population.

Board member Tony Rose had asked for information about the number of students who don’t get vaccinations because of religious or other reasons.

“I think it’s 15 kids in your entire system (who) have an exemption for medical or religious reasons,” Shapley-Quinn said. None of the pertussis cases involved those students, she said.

 

THE SCHOOL SYSTEM should have done more to inform parents at schools found to have cases of pertussis, Rose and board member Patsy Simpson said.

“I do believe the school system has an obligation to inform our parents whether their child is within three feet or whatever” of a child with pertussis, Simpson said. “I found out there was an outbreak at my son’s school through the newspaper.”

Rose agreed schools could provide that information to parents without creating unwarranted fears. He said school system employees had called him to ask if it was safe to go to school.

Shapley-Quinn noted a letter was sent in January to families throughout the school system to let them know about symptoms of pertussis and to inform them what to do if they appeared.

Board chairwoman Jackie Cole noted students and families could be exposed to the disease outside of school, such as at church.

Shapley-Quinn said the health department’s overall strategy has been to protect children and adults without causing undue alarm.

“If this was meningitis, which kills children, we’d be doing something completely different,” she said.

In situations involving younger children in child-care centers, she said, the department has been more active in monitoring potential problems because of greater health risks at that age.


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