Pertussis claims life of Texas infant

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Registered: 03-25-2003
Pertussis claims life of Texas infant
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Sun, 06-01-2003 - 11:49pm
May 30, 2003

UNPROTECTED PEOPLE #55: PERTUSSIS CLAIMS LIFE OF TEXAS INFANT

The Immunization Action Coalition (IAC) publishes articles about

people who have suffered or died from vaccine-preventable diseases

and periodically devotes an "IAC EXPRESS" issue to such an article.

This is the 55th in our series.

On April 30, Serena Gabrielle King, age 27 days, succumbed to

whooping cough in Austin. She is the third person in Texas to die

from the disease this year. Texas, which has one of the lowest

rates of childhood immunization in the nation, has seen a startling

increase in the incidence of pertussis since 2000. Travis County,

where Austin is located, experienced one case in 2000, 54 in 2001,

and 111 in 2002.

Infants are particularly likely to contract the disease. According

to the "MMWR Summary of Notifiable Diseases," in the years 1999,

2000, and 2001, between 22 to 27 percent of pertussis cases reported

in the United States occurred in infants under 7 months of age. The

increased incidence of pertussis puts newborns like Serena at

considerable risk: Infants do not receive the first dose of DTaP

until 6 weeks to 2 months of age, leaving them extremely vulnerable

in the earliest weeks of life.



Following are a newspaper article as well as a letter to the editor,

written by Serena's grandfather. As both make clear, the only hope

of sparing other infants from Serena's fate lies in increasing

rates of childhood immunization.

The newspaper article, written by Mary Ann Roser, was published in

the "Austin American-Statesman" on May 7. We are grateful to the

"Austin American-Statesman" for permission to reprint it. The

letter to the editor, written by Troy Rickabaugh, was published

May 27 in the newspaper "Mineral Wells Index."

*************************



May 7, 2003

Too Young for Shot, Austin Infant Dies of Whooping Cough

By Mary Ann Roser

A month-old infant died of whooping cough last week in Austin, the

first such death in Travis County in years and a reminder that the

highly contagious disease is in the community and can kill babies.

Whooping cough, also known as pertussis, is on the upswing, and

Travis and Burnet counties were among the hardest hit in the state

last year. Officials at the Austin/Travis County Health and Human

Services Department investigated people who came in contact with

the baby--including students at Crockett High School, which the

mother attended, and the doctor's office where the disease went

undetected--but could not find the source of the whooping cough,

health department spokesman Bob Flocke said.

"We've exhausted all the leads and all the contacts," Flocke said

Monday. "We don't have anywhere else to go." The health department

sent a letter to teen parents of children in day care at the high

school, letting them know the pertussis exposure could have

occurred there, Flocke said.

Whooping cough starts with cold symptoms and often is spread by

older children or adults who do not get as severe a case or the

characteristic "whoop" that younger children get.

Lacee King, the baby's mother, said she hoped the loss of her

27-day-old daughter, Serena, would educate people, including the

medical community, about pertussis. Her daughter was not diagnosed

until just before her death. She also wants parents to be aware of

the importance of vaccinations. "I hope it can make people aware of

what can happen from not being vaccinated," said King, 16.

Serena King was too young for the vaccine, which is given at

2 months, 4 months and 6 months, with boosters at 18 months and

4 years. Someone who might not have been vaccinated could have

passed the disease to her. Texas ranks near the bottom of the

states in childhood vaccination rates. Some parents opt out of the

pertussis vaccine because of side effects, such as fever. The

vaccine is about 80 percent effective, though protection wanes as

the child ages.

Serena, born April 3, developed jaundice and cold symptoms about

two weeks after she was born, and King took her to Carousel

Pediatrics. The baby was seen by a nurse, who told King that her

child had normal nasal problems, King said.

When Serena began coughing and vomiting, King took her back and was

told her daughter had gastroesophageal reflux, a digestive problem,

King said. When the baby's condition worsened April 27, King and

her husband, Rickey King, rushed her to the hospital. A day later,

she was diagnosed with pertussis, and on Wednesday, she was dead.

"I think Carousel Pediatrics had a big part in this," Lacee King

said.

Glenn Wood, the senior physician at Carousel, said pertussis is

hard to diagnose early on. Dozens of children come in every day

with coughs and runny noses, and it would not be feasible to test

every child for pertussis, he said. After reviewing Serena's chart

and records of her visits on April 16 and April 22, he said that

while his nursing staff treated the child, "There's not anything I

would have done differently based on what I'm seeing."

"It's a terrible, unfortunate case, but it illustrates how

important it is to get vaccinated," he said. "There are a lot of

kids behind on their vaccinations, and a lot can't get in to see

their doctor, especially kids on Medicaid and on CHIP," the

Children's Health Insurance Program.

For a long time, pertussis was seen as virtually eradicated. But in

recent years, it has made a comeback. Death rates in Texas have

risen from zero or one a year to five in 2001 and four in 2002,

said David Bastis, program manager in the immunization division at

the Texas Department of Health. So far this year, two deaths have

been reported in Texas. A check of records to 1990 showed no other

pertussis deaths in Travis County.

Why the increase in deaths statewide? "There's more pertussis out

there because of low immunization coverage and waning immunity in

adolescents and adults," Bastis said. "That increases the chance

that babies and infants will get pertussis." Last year, 111

pertussis cases were reported in Travis County, up from 54 in 2001

and one in 2000. There were 235 pertussis cases in Burnet County in

2002, more than any in Texas.

Troy Rickabaugh, Lacee King's father, called the newspaper about

his granddaughter's death in the hope of educating others about the

potentially deadly consequences of pertussis. "If we can save one

life," he said, "that would be wonderful."

***************************



May 27, 2003

Don't Let a Child Die over Lack of Immunizations

Dear Editor,

My beautiful granddaughter is dead.

Serena's death was totally preventable, but someone made a bad

decision not to get immunized for whooping cough.

Her mother, my daughter, went to all her prenatal doctor

appointments, watched her diet, took care of herself so she could

take care of her baby.

Serena was too young to even begin getting vaccinations, but you

can be assured she would have received all her shots on time. All

the love and caring our family gave Serena ultimately made no

difference because someone else chose not to be immunized.

Pertussis, or whooping cough, is a totally preventable disease. But

only if everyone lives by the Golden Rule and does the right thing.

No one has the right to make a decision for himself that can hurt

others. And that's what happens when all children are not

immunized. Their parents make the wrong decision, and someone

else's child gets hurt!

Serena lived 27 days in the loving arms of her family. She died

because someone in the community did not get immunized.

You can do something to make sure other families don't suffer the

pain we are suffering. You can get immunized. And you can ask your

state senator to support two bills pending in the Texas Senate:

HB 1920 and HB 1921. One bill calls for the Texas Department of

Health to keep a database that doctors can use to see if a child

needs to be immunized. The other provides vaccines for children who

don't have the insurance coverage to pay for the immunizations.

Please, don't let another Serena die needlessly.

Troy Rickabaugh

Austin

***************************

To access this and other Unprotected People stories, go to:

http://www.immunize.org/stories

DISCLAIMER: The Immunization Action Coalition (IAC) publishes

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for which the author(s) are solely responsible.

DO YOU KNOW OF PUBLISHED ARTICLES ABOUT UNPROTECTED PEOPLE? Please

let us know if you find articles or case reports about people who

have suffered or died from vaccine-preventable diseases that have

appeared in the general or scientific media. Send information about

articles or case reports to "IAC EXPRESS" by email to

admin@immunize.org or by fax to (651) 647-9131.

===================================================================

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Managing Editor: Dale Thompson (dale@immunize.org)

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ISSN: 1526-1786

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past issues, please visit http://www.immunize.org/express

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Eve

 
 

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iVillage Member
Registered: 03-27-2003
Mon, 06-02-2003 - 3:05pm
“Texas, which has one of the lowest

rates of childhood immunization in the nation”

On the deceptive manner in which these rankings are calculated in Texas;

http://vaccineinfo.net/immunization/rates/index.shtml

(“Saying that Texas has an immunization rate problem is as misleading as it is inaccurate.. The CDC's National Immunization Survey of children 19-35 months of age is the source of the Texas vaccine coverage estimate of 74.9% resulting in Texas being ranked 43rd in immunization rates…The survey is conducted when a child is 19-35 months old, and only counts children who have received all doses in the CDC's benchmark: 4 doses of DTP vaccine, 3 doses of polio vaccine, and 1 dose of measles containing vaccine. Even though a child may be fully vaccinated according to Texas Law at the time of the survey, they are not counted by the CDC in the fully vaccinated group. It is interesting to note that any child counted as fully vaccinated by the CDC, is actually over vaccinated according to Texas Law…1) 93.3±1.8 % of Texas children have received all 3 Texas age appropriate doses of the DTP vaccine. 2) Even though Texas law requires the third dose of the polio vaccine to be on or after the 4th birthday, an amazing 87.6±2.7 % of toddlers in this age group have receive 3 doses of the polio vaccine 3) 90.4±2.3 % have received 1 dose of measles containing vaccine

While the numbers are even higher for Texas children enrolled in child care facilities who are fully immunized: DPT/Td 95.7%, polio 97.3%, measles 97.7% , the number of Texas Public School children who are fully vaccinated climb to: DPT/Td 98%, polio 99%, and measles 99%.”)

In reality, the pertussis vaccination rates are currently the HIGHEST on record, in Texas and elsewhere in the nation, leaving the experts, as quoted in a recent Houston Chronicle article, to say they “cannot explain” the rapid rise in pertussis cases nationwide. (though be assured they would have no trouble “explaining” such increases if they were accompanied by DECLINING vaccination rates, lol!) That simply is not the case in this instance, however.

“"I hope it can make people aware of

what can happen from not being vaccinated," said King, 16.

Serena King was too young for the vaccine, which is given at

2 months, 4 months and 6 months, with boosters at 18 months and

4 years. Someone who might not have been vaccinated could have

passed the disease to her. “

Far more likely is that the infant was infected by an older, FULLY VACCINATED individual whose immunity had waned and in whom symptoms tend to be milder than in young children, vaccinated or not. That the mother was regularly in a high school setting makes this even more probable.

“"There's more pertussis out

there because of low immunization coverage and waning immunity in

adolescents and adults," and “Serena's death was totally preventable, but someone made a bad decision not to get immunized for whooping cough. “

See above for discussion of the actual coverage rates in Texas. The waning immunity in adolescents and adults is more likely the true issue here, and there is NO pertussis vaccine approved for those over the age of 7 at this point, making the “this happened because someone didn’t/wasn’t vaccinated/totally preventable” angle pure hogwash. Just more insubstantial grist for the propaganda mill.

“And you can ask your

state senator to support two bills pending in the Texas Senate:

HB 1920 and HB 1921. One bill calls for the Texas Department of

Health to keep a database that doctors can use to see if a child

needs to be immunized. The other provides vaccines for children who

don't have the insurance coverage to pay for the immunizations. “

Ah, yes, "wonderful" bill, which changes the current opt-in system to an opt-out one in which parents who do NOT want their child’s medical records released automatically to the health dept. et al must sign on as “objectors” to be collected in a separate database.

The legislators backing this have been esp. unresponsive to public input, going so far as to refuse to schedule a public hearing on the bill. This one had strong opposition from many fronts, but it seems the anti-choice forces won the day.

Oh, and Eve, you must have missed my response to you from below re‘ pertussis, or is it just that you have nothing to say?; http://messageboards.ivillage.com/n/mb/message.asp?webtag=iv-ppvaccinedb&msg=2815.18


Kimberly

iVillage Member
Registered: 06-01-2003
Mon, 06-02-2003 - 9:22pm
What a sad case. I'm not certain this does much for either pro- or anti-vaccination philosophies. I do wonder if she had been accurately diagnosed earlier, could that have helped to save her?

"On April 30, Serena Gabrielle King, age 27 days, succumbed to

whooping cough in Austin. She is the third person in Texas to die

from the disease this year. Texas, which has one of the lowest

rates of childhood immunization in the nation, has seen a startling

increase in the incidence of pertussis since 2000. Travis County,

where Austin is located, experienced one case in 2000, 54 in 2001,

and 111 in 2002."

With whooping cough so prevalent in the area, why weren't her symptoms useful to diagnose the disease earlier?

Kathy

iVillage Member
Registered: 03-19-2003
Mon, 06-02-2003 - 11:38pm
First this is horriable and I can not help but to cry reading it. Secondly..I think that her not being diagnosed for it is part of the reason...If it had NOT been for my daughters ped Lindsey would surely have died.

I think that ALL doctors NEED to be updated on Pertussis and what to look for. It is NOT that hard to tell...I am sorry...NOT at all..once they start to cough there is NO Mistaking it...not in a child and it sure was not hard to tell in my DH!

I also do not think that it has anything to do with weither or not you are vaxed...being how you catch it. See those who ARE vaxed for it WONT spread it...BUT the issue is all the kids over age 7 where the vax has worn off and of course ALL the adults. We either have to start vaccinating babies for this earlier OR get older children and adults vaccinated for it. THAT is MY Opinion though.

I watched my daughter suffer and believe me it was NOT pretty. I think its awful that this little girl died...Personally I dont know about Tx and how many get shots and how many dont,BUT on Pertussis.com web site it shows that TX has the highest rate of Pertussis in the nation. Is it not enough children being vaxed for it? Maybe, but I think the majority of this comes from older children and adults.

I pray for this little girls family...I praise God everyday that Lindsey made it through this.

By the way has anyone heard from Missy? I would LOVE to know how Cole is? If anyone knows please let me know...

Carla

Carla,

Mommy to...MariaElena,Lindsey,Jac

Avatar for kidoctr
iVillage Member
Registered: 03-25-2003
Tue, 06-03-2003 - 3:37pm
Kimberly - where in the world did Dawn get her information? According to the Texas Department of Health, Dawn's figures are based on incorrect information:

http://www.tdh.state.tx.us/immunize/schmain.htm#require

"Minimum State Vaccine Requirements for Texas Children

Age

15 mos. through 4 years

**Three doses polio vaccine**

**Four doses DTP/DTaP (Fourth dose not required until 18 months.)**

One dose Hib vaccine on or after 15 months of age, unless a primary series and boosterg have been completed

One dose MMR vaccine received on or after 1st birthdayb

One dose of varicella vaccine received on or after 1st birthdayc

Hepatitis A vaccine (selected counties)d:

2 years-One dose of hepatitis A vaccine;

3 through 4 years-Two doses of hepatitis A vaccine (1st dose on or after 2nd birthday)"

I see that Dawn's piece was written in Feb 2003 so "old info" is not to blame. Care to explain? Hhhmm....perhaps I need to email Dawn about this as well.

Eve - who did miss your response earlier and will read it later.

 
 
Avatar for kidoctr
iVillage Member
Registered: 03-25-2003
Tue, 06-03-2003 - 5:03pm
Kathy - "I do wonder if she had been accurately diagnosed earlier, could that have helped to save her?"

That's a very reasonable question and could *possibly* have impacted her final outcome. Unfortunately, the initial symptoms of pertussis overlap with many other illnesses (the typical symptoms during the initial catarrhal stage is simply runny nose, low grade fever, mild cough) and due to the success of the vaccination program, pertussis is no longer at the top of the differential list in a child with cold symptoms and a cough. Oftentimes, by the time that the symptoms are obviously due to pertussis, antibiotics do not alter to course but does make the infected person less contagious. That's a real dilemma with this vaccine - pertussis disease (morbidity/mortality) and antibiotic (over)use/resistance vs vaccination/disease control/complacency in the diagnosis of pertussis.

Eve

 
 
Avatar for kidoctr
iVillage Member
Registered: 03-25-2003
Tue, 06-03-2003 - 5:52pm
Carla - I know what you mean...I thought of you when posting this story. Sorry to bring back bad memories...

Eve

 
 
iVillage Member
Registered: 03-19-2003
Tue, 06-03-2003 - 8:43pm
Eve,

That is ok...I think that VPDs are important. I have to say that Lindsey had the SAME tests as that little girl. It still took 2 weeks to finally get a positive result. She had a test for Pertussis Oct 1st...it was THE first thing her PED tested for. Oddly enough the lab came back saying it was neg. I believe whole heartly that the lab screwed up. Cause in two weeks it was ++++ She has been starting to cough...it sounded at first like she would cough all the air out her. The morning my mom and I had taken her to the ER...and the head ped told me there was nothing wrong with her she was coughing so bad. If it was not for the INSISTANCE of her ped that she NOT leave that place without another Pertussis test I KNOW Lindsey would have died. NO doubt in my mind.

This is why I believe more doctors need to be taught more about Pertussis. It just seems to me that these children and adults are NOT being diagnosed sooner because NOONE knows what to look for. JMO though.

Carla

Carla,

Mommy to...MariaElena,Lindsey,Jac

Avatar for kidoctr
iVillage Member
Registered: 03-25-2003
Tue, 06-03-2003 - 11:01pm
I agree Carla - that's a lot of where the phrase "victim of its own successes" comes from....vaccines have been so effective in bringing down the incidence of VPDs that they can be overlooked by some adult doctors (ie internists, family medicine doctors) who no longer see these illnesses and are less familiar with them. You can be sure, though, that when pertussis and measles were endemic, doctors were very familiar with them. In this day and age, the fact that doctors don't recognize them as readily is an unfortunate testament to how well vaccines have been working. Pediatric residents these days may actually get through an entire residency without ever seeing chickenpox, HiB meningitis, etc. On the one hand, that's a good thing - less VPD morbidity/mortality, but on the other hand - there may be a delay in VPD diagnoses by those no longer familiar with them. It's been argued frequently that such delay or lack of diagnoses have artificially added to the drop in VPD incidence, but I don't believe that this has made a significant contribution compared to what vaccines have done themselves.

Eve

 
 
iVillage Member
Registered: 03-19-2003
Wed, 06-04-2003 - 9:02am
Sorry about this darn hat...

I agree that its a great thing these vaxes have been working...yet I think its the responsiblity of the schools and hospitals these new doctors are going to to make sure that they have at least seen a tape of pertussis or listened to an audio of it. I think that they should be TAUGHT what to look for even IF they have not seen it. Cause its obvious that Pertussis is on the rise again and lets face it what else is going to make a come back?

I will never forget when my mom called her dr to get the antibiotics for her and my dad...he is not that young either lol..he said " Pertussis? I have not seen that in 30 years...I would not even know what medication to give you right now....I have to call you back after I check the medical book." Needless to say my daughters PED told us what to tell him .... UGH..these are just some of the things I think we should be up on is all.

Carla

Carla,

Mommy to...MariaElena,Lindsey,Jac

iVillage Member
Registered: 03-27-2003
Mon, 06-09-2003 - 9:59pm
<
until 6 weeks to 2 months of age, leaving them extremely vulnerable

in the earliest weeks of life>>

If vaccines are so safe to give to newborns, why don't they give the first dose

of DTaP at birth? I mean, pertussis in children under the vaccinating age is always

being touted as a major problem. Apparently 18% of pertussis cases occur in infants

younger than 3 months If maternal antibodies are not protecting them, then why wait till 6 weeks or so?





<
written by Serena's grandfather. As both make clear, the only hope

of sparing other infants from Serena's fate lies in increasing

rates of childhood immunization>>

How is increasing childhood vaccination rates going to prevent adults from

transmitting pertussis to infants? There are approximately 208 million adults in the US, not to mention all those under 18 who are no longer 'immune' or never were, who could transmit pertussis to infants too young to be vaxed, those who are undervaxed or unable to be vaxed, or those who remain susceptible despite being vaxed. It's ridiculous to say that vaccinating 'children' is the 'only hope of sparing infants'



<>

This is interesting because for many years babies received only 3 doses of DPT. Pertussis 'appeared' to be eradicated?, even though 1. only a minority of the population was ever vaxed (adults would have still been transmitting pertussis to susceptible babies/children just as they are now) and 2. everyone single baby/child vaxed in the 40's, 50's and 60's at least, was undervaxed by 2 doses. Strange indeed

Jan



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