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San Diego County Health Officials Warn Of Looming Whooping Cough Epidemic

February 27, 2018 1:39 p.m.

San Diego County Health Officials Warn Of Looming Whooping Cough Epidemic


Dr. Mark Sawyer, infectious disease specialist, Rady Children's Hospital

Related Story: San Diego County Health Officials Warn Of Looming Whooping Cough Epidemic


This is a rush transcript created by a contractor for KPBS to improve accessibility for the deaf and hard-of-hearing. Please refer to the media file as the formal record of this interview. Opinions expressed by guests during interviews reflect the guest’s individual views and do not necessarily represent those of KPBS staff, members or its sponsors.

>>> San Diego health officials are watching and waiting for a new infectious disease epidemic. One that is especially dangerous for infants. Whooping cough seems to be cyclical rolling back every 3 to 5 years. The last big outbreak in San Diego was 2014. Doctors believe this year or next will be seeing higher than average numbers of whooping cough. The problem is getting more pregnant women immunize so they can pass on protection to their newborns. Mark Sawyer joins me. Doctor Sawyer Welcome .
>> thank you for having me.

>>> Whooping cough or protest this is a nasty disease for anyone. Tell us about the symptoms and how contagious it is.
>> The symptoms vary a little bit depending on age. For young infants it presents as a typical whooping cough which is a series of cough episodes followed by an inspiration that makes that whoop sound as the baby present. In older children and adults, it is much more subtle. It is simply just a cough that goes on and on. In fact, I have often heard that the Chinese refer to it as the hundred day cough. Anyone who has had pertussis as an adult can testify to the annoying persistence of the cough.

>>> Why is the disease dangerous for newborns and infants? Three newborns, first of all their immune system is not fully mature. They don't deal with most infections as well as older children and adults. In particular, whooping cough or proptosis as it's referred to medically affects the lungs and the heart in newborn infants. They often will have pauses in their breathing sometimes alarmingly long pauses. It also affects the pulmonary vessels that go into the lungs from the heart. Babies who die from proptosis usually have problems with both her lungs and their heart.

>>> Last year there were 1154 whooping cough cases reported in the county the third-highest count in four years. What are you seeing in terms of infections at rating so far this year? Soon we have seen several babies in the hospital already this year. Processes tends to peak in the spring, late winter or early spring. We are just at the beginning of a rise in cases here in San Diego. Every year we have babies both in the hospital and unfortunately often in our intensive care unit at the hospital with proptosis.

>>> With the state report, there are 16 mothers whose babies come down with pertussis. The majority were not vaccinated during the third trimester as recommended. Why do you think some expecting mothers are not getting immunized. City and it is a relatively recent recommendation that we immunize pregnant women during pregnancy. It started in 2010 with the epidemic we had at that time. California was ahead of the rest of the country in making a recommendation to immunize pregnant women. We have come to realize that that is the only way we can effectively present -- prevent disease in infants. For years, pregnant women were told not to take any medicines, get vaccines, or avoid anything they can during pregnancy. That legacy is still with us even though we have now clearly shown that immunize against whooping cough during pregnancy not only prevents the women from getting it it protects the baby. We have more education to deal with public and physician's.

>>> Is the whooping cough vaccination rate low amongst pregnant women in San Diego County?
>> Yes we have some women here locally which is similar to the state and national data which is 50% of pregnant women are getting vaccinated with her pregnancy. In fact the recommendation is to get one with each pregnancy.

>>> One thing we have learned is that one pertussis vaccine will lot -- not last a lifetime. Tell us about that.
>> There are two different versions of the vaccine. One that is used in young children and a different one used in adolescents and adults. Both vaccines work well after you receive them. Over a period of seven years, that immunity gradually decreases. We are in a situation where we can only partially protect people because the vaccine immunity goes away over time.

>>> Do we know the why the outbreak of whooping cough is cyclical? Does that have anything to do with the limited the facts of the vaccine ?
>> It is curious that pertussis and actually many infectious diseases go in cycles every few years in different communities. There is also geographic variations. Some communities have more or less in any given season. We don't understand why that happens. I don't think it's related to the vaccine. And it's decreased immunity over time. We saw the cycles before we had any vaccine. We continue to see them now despite vaccination which is not reaching lots of the population. I think this is a phenomenon of the infection itself. We don't understand why it happens.

>>> When it comes to whooping cough infections, San Diego sees a higher spike in the number of cases compared to the rest of the state. Do we know what's behind that?
>> I don't think we have all the answers to that phenomenon. That has been seen over number of years. One thing I can say is the local physician community particularly the pediatricians of San Diego have a close working relationship with our health department. They go out of their way to make sure they report suspected cases, they go out of their way to diagnose pertussis when they suspected, part of it is we are finding more cases than other diseases -- communities do because we are aggressively looking for them. At the same time there probably is a real increase compared to other communities and we don't understand why that is happening

>>> San Diego is moving past the serious hepatitis outbreak. We sought outbreak of flu this season. Now this morning about whooping cough. From your perspective, is there something the public needs to relearn about the threat of infectious disease?
>> It is too easy to become complacent about infections that have not been in the news that you have not personally experienced. All of these infections are out in our community. If we let our guard down, they will rise up and create epidemics. That is true for influence, whooping cough, people need to take advantage of the best protection they can get which is to be vaccinated against these illnesses.

>>> Once again, if a pregnant women's Doctor does not recommend a whooping cough vaccine, should the pregnant woman bring it up herself?
>> Absolutely. Some physicians are unaware of this recommendation or don't have the facility in their office to get the vaccine there. they should at least be referring pregnant women to sources where they can receive the vaccine. All pregnant women should be empowered to bring this topic up with their physician. It is the best thing they can do to prevent their baby from getting sick with the whooping cough.

>>> I have been speaking with Doctor Mark Sawyer infectious disease specialist at Rady Children's Hospital. Doctor Sawyer thank you very much.
>> Thank you.