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WASHINGTON, Oct. 23 (UPI) -- Across the United States, cases of the deadly disease whooping cough are appearing more frequently than in decades and public health officials worry the increases are due at least in part to the reluctance of some parents to vaccinate their children.
The trend alarms officials because whooping cough, formally known as pertussis, was once a devastating disease in the United States, infecting as many as 270,000 people each year and causing 10,000 deaths, prior to the introduction of a vaccine in the 1940s.
"It really is a serious thing," Dr. Martin Myers, executive director of the National Network for Immunization Information in Alexandria, Va., told United Press International. "A multi-fold increase in pertussis is very worrisome. Nationally, we're at levels we haven't seen since the 1960s," Myers said.
The vaccine largely kept pertussis in check, cutting the number of cases to a low of 1,010 in 1976. But the disease has rebounded in recent years, with more than 7,800 cases reported in 2000, including 17 infant deaths -- which some experts think is a gross underestimation. In 2002, pertussis shot up to more than 9,700 cases.
This year may be even worse, officials said. From New York City to Washington, D.C., local outbreaks of pertussis consist of more cases than they have seen in 25 years or more.
Oregon has seen 347 cases so far this year, on track to a 30-year high. Seattle has 189 cases, including the highest number of infected infants in 25 years. Texas has had 32 cases in its panhandle region, the most there in 35 years.
Several other states, including Illinois, North Carolina, Utah and Wyoming, also are seeing increased numbers of the disease.
Health officials say one of the reasons for the outbreaks is parental refusal to vaccinate children due to misguided concerns about side effects. Because the vaccine has all but eliminated pertussis, the current generation of parents has very little experience with the disease and may be unaware of the devastating and life-threatening conditions that stem from pertussis infection.
"People don't see the diseases very much and as a consequence they've forgotten how bad these diseases are," Myers said. "They're not scared of them like they used to be and don't realize as vaccine coverage goes down these diseases come back."
Caused by the Bordatella pertussis bacterium, pertussis sometimes is called the 100-day cough due to the prolonged illness it can cause. It produces particularly frightening effects in children. It can cause them to turn blue from lack of oxygen, due to seemingly unending coughing fits, which result in a whooping kind of sound as they gasp for breath.
Westchester County, N.Y., which typically sees only five or six cases per year, has reported 28 cases since August. The outbreak began among four children who had not received the pertussis vaccine because their parents made conscious decisions not to immunize them, Dr. Joshua Lipsman, Westchester County's health commissioner, told UPI.
All four initial cases -- and quite likely the entire outbreak -- probably could have been prevented had the children been vaccinated, Lipsman said.
Texas is enduring a similar situation. The state experienced four deaths from the disease this year, including one in a 2-1/2-year-old girl who had not been vaccinated, David Bastis, program manager in the immunization division of the Texas Department of Health, told UPI.
In Seattle, nearly one-third of the 21 infected children between ages 2 and 7 had not been immunized. Mostly, their parents lacked access to medical care, but one or two of the parents were philosophically opposed to vaccination, Dr. Jeff Duchin, chief of the communicable disease control, epidemiology and immunization section of Seattle and King County's public health department, told UPI.
"There are people here who intentionally decide not to receive the pertussis vaccine," Duchin said. "Alternative healthcare is very big out here and anti-vaccination is more common than we'd like it to be."
Barbara Loe Fisher, president of the National Vaccine Information Center in Vienna, Va., which was founded by parents whose children developed serious illness or died after being immunized, who has lobbied against certain vaccines, said the current pertussis inoculation can cause serious side effects, including seizures and permanent brain damage.
Most health officials disagree with this view, however.
"There are certain children ... who are genetically vulnerable" to these severe effects, maintained Fisher, whose son developed brain swelling that eventually led to brain damage after receiving an older pertussis vaccine called DTP, which was meant to protect against diphtheria, tetanus and pertussis.
The older inoculation was replaced in 1996 by the current vaccine, DTaP, for which Fisher's group lobbied and which most health experts consider safer and not linked to severe side effects.
Parental reluctance to vaccinate their children concerns health officials because it has implications not just for the individual child but for communities at large.
"It doesn't take that many unvaccinated children to allow for these outbreaks to occur because pertussis is highly contagious," David Klein, bacterial respiratory vaccines program officer at the National Institute of Allergy and Infectious Diseases in Bethesda, Md., told UPI.
In situations where there is a large number of kids, such as daycare centers, if one child comes down with the disease, "it is very likely that you have a prime situation for spread of a very infectious agent," Klein said.
Despite the record number of pertussis cases in these local outbreaks, the Centers for Disease Control and Prevention in Atlanta says on a national level the disease does not appear to be increasing.
"There's always outbreaks every year ... It doesn't look like this year is dramatically different than recent years," Dr. Margaret Cortese, medical epidemiologist with the CDC's National Immunization Program, told UPI.
Cortese acknowledged that over the past 10 years pertussis has been increasing and there have been more outbreaks in adolescents, but she said this could be due to better reporting and an improved diagnostic test. In addition, the disease is significantly under-reported in adolescents and adults, so the real numbers could be up to 10 times more than the official figures, she said.
Cortese doubted whether parents not vaccinating their children due to safety concerns were contributing to the outbreaks. But, she added: "All the misinformation that is given out by the anti-vaccine groups definitely do have an affect on parent's perception of vaccines. Every year we do have cases of pertussis in infants of parents who declined to give their children vaccines."
Myers, however, thinks vaccination coverage has fallen "to a point in the United States where we're at risk" of several diseases. "It's pertussis now but it could be other diseases," including measles, meningitis and diphtheria, he said.