Pertussis, the whooping cough bacteria -- CDC photo

The number of cases of whooping cough in Washington state increased by more than 50 percent between 2010 and 2011, the State Department of Health reported Wednesday.

Last year there were 912 cases in the state — the highest in six years — up from 608 cases reported in 2010.

In recent years, adolescents and adults have accounted for an increasing proportion of cases, health officials said.

“The number of reported cases is just the tip of the iceberg,” State Health Officer and pediatrician Dr. Maxine Hayes said. “Many young people and adults who get pertussis may not know they have it and don’t seek medical attention.

Whooping cough, also known as pertussis, is a highly contagious respiratory illness spread by coughing and sneezing.

Initially, an infection may seem like a cold, but patients then go on to develop a severe, persistent–often wracking–cough that can last for weeks.

The coughing fits can be prolonged and are often followed by a long inhalation that causes the “whooping” sound that gives the disease its name.

The bouts of coughing can leave victims breathless and unable to eat, drink or sleep. Complications of the infection include pneumonia, seizures and death.

Whooping cough can affect people of all ages — but is most serious in infants, especially those too young to get vaccinated or who aren’t fully protected.

Adolescents and adults often get a much milder case of whooping cough, but they can still spread it, the Department of Health warned.

There is a vaccine that can prevent infection, but it is not effective in newborns or infants. Health officials therefore recommend that anyone who has contact with newborns and infants be vaccinated or, if they have been vaccinated, to make sure their vaccination is up-to-date.

Who should get the vaccine?

The U.S. Advisory Committee on Immunization Practices has issued new pertussis vaccination recommendations:

• Pregnant women to get pertussis vaccine (Tdap) later in pregnancy (after 20 weeks’ gestation). Women who get Tdap vaccine before or during pregnancy pass on extra protection against pertussis to their babies.

• Anyone who takes care of or has close contact with babies to get pertussis vaccine, ideally at least two weeks before beginning close contact with the infant. This includes siblings of infants who should be up-to-date on DTaP and other recommended immunizations.

• Tdap vaccine is available for adolescents and adults through age 64. But adults 65 and older who expect to have close contact with babies younger than 12 months should get a dose of Tdap to help protect the baby from pertussis.

• Health care workers of all ages who have contact with infants should get vaccinated too.

Protection wears off so you may need a booster

Most people get a series of pertussis vaccines when they’re kids, but protection wears off over time. The Department of Health recommends people substitute a Tdap vaccine for one routine tetanus (Td) booster, which is needed every 10 years; people should get it sooner if they’re in close contact with young kids or live in an area where there are pertussis cases. There’s no minimum time period between getting Td and Tdap vaccines. Only one Tdap vaccine is recommended in a person’s lifetime.

Vaccines available for free for kids under 19

All recommended vaccines are offered to all kids under 19 at no cost through health care provider offices participating in the state’s Childhood Vaccine Program.

Health care providers may charge an office visit fee and a fee to give the vaccine, called an administration fee.

People who cannot afford the administration fee can ask their regular health care provider to waive the cost.

Adults should talk to their insurance carriers about coverage for pertussis vaccine.

To learn more:

• Visit the PKIDS Online pertussis information page.

• Contact your local health agency  or the Department of Health’s Office of Immunization and Child Profile at 360-236-3595.

The report, America’s Health Rankings, is published jointly by United Health Foundation, American Public Health Association and Partnership for Prevention.

Top-ranked states:

1. Vermont
2. New Hampshire
3. Connecticut
4. Hawaii
5. Massachusetts

Bottom-ranked states:

Washington State Trends:

Among the trends that drove down Washington State’s rankings this year were rises in the rates of obesity, diabetes, and smoking and a decline in high school graduation rates.

The annual study, America’s Health Rankings, assesses a state’s health using not only standard measures of health, such as infant mortality rates, but also by such measures as smoking, obesity, and high school graduation rates — all of which provide indications of a population’s overall health status.

High school graduation rates are considered in the ranking because, in general, graduates tend to go on to have fewer health problems later in life.

Among the trends in Washingtion the report found troubling were:

• A marked increase in obesity rates among the state’s residents over the past decade from 18.8 percent to 26.2 percent, meaning that 1.6 million of Washington state’s adults are now obese.

• A steady increase in the the rate of diabetes, which rose from 6.3 percent five years to 7.3 percent in 2011, meaning that 391,000 adults in the state now have the disease.

• And a decline in the number of students graduating from high school in four years to the lowest rate in seven years, 71.9 percent, placing the state 38th in the nation for high school graduation.

Other challenges facing the state identified by the report were a low immunization rate among children, 88.6 percent. That rate makes the state 39th in the nation.

National progress stagnates

The report found that the nation made no progress in improving its overall health this year with modest improvements being offset by a number of troubling trends.

Among improvements were declines in smoking, cardiovascular deaths and preventable hospitalizations:

• Smoking cessation: 17.3 percent of the population smoked in 2011, down from 17.9 percent in 2010 – a 3.4 percent decline since 2010; a 25.4 percent decline since 2001.

• Cardiovascular deaths: 270.4 deaths per 100,000 in 2011, down from 278.2 deaths per 100,000 in 2010 – a 2.8 percent decline since 2010; a 22.2 percent decline since 2001.

• Preventable hospitalizations: 68.2 preventable hospitalizations per 1,000 Medicare enrollees in 2011, down from 70.6 preventable hospitalizations in 2010 – a 3.4 percent decline since 2010; a 17.3 percent decline since 2001.

Walgreens in Capitol Hill will offer flu shots at no charge to for adults and children age seven and older who are uninsured and cannot afford to pay.

Walgreens and Public Health – Seattle & King County are partnering to offer flu vaccinations at no charge on Saturday, Dec. 17 from 10 a.m. to 6 p.m. at the Walgreens located at Broadway and Pine (1531 Broadway) on Capitol Hill in Seattle.

Vaccines will be offered at no charge for adults and children age seven and older who are uninsured and cannot afford to pay.

Health experts recommend that everyone get the flu vaccine to protect their health and the people around them.

The flu can cause significant lost time from work and school, as well as the expense of doctor visits. In some instances, it can also cause hospitalization and even death.

The flu clinic is an excellent opportunity for people who do not have health insurance to get a flu vaccination at no charge.

No appointments needed.

Date:

Saturday, Dec. 17, 2011

Time:

The flu clinic is open from 10 a.m.- 6 p.m. or until there is no more vaccine available.

Where:

Walgreens, 1531 Broadway, Seattle

Photo Credit: Dan Higgins/CDC

It is not too late to get your flu vaccine, if you have not gotten one already, health officials note.

And if you are uninsured and cannot afford to pay, this Saturday there’s an opportunity to get the shot for free.

Walgreens and Public Health – Seattle & King County are partnering to offer flu vaccinations at no charge on Saturday, Dec. 3 from 10 a.m. to 6 p.m. at the Walgreens located at 17524 Aurora Ave. North in Shoreline.

Vaccines will be offered at no charge for adults and children age seven and older who are uninsured and cannot afford to pay.

No appointments are needed.

Flu activity is currently low in King County, which means there is still time to protect yourself and your family from the flu, health officials said.

Flu shots are also widely available at doctors’ offices, clinics, pharmacies, Public Health centers and other providers.

• To find a flu shot clinic, visit www.flucliniclocator.org.

• For complete information about seasonal influenza, including where to get a flu vaccine, please visit www.kingcounty.gov/health/flu.

By Dr. James Kublin

Today, December 1st, is World AIDS Day, and to mark the occasion the HIV Vaccine Trials Network, which is headquartered at Fred Hutchinson Cancer Research Center in Seattle, would like to debunk the top 10 myths about HIV vaccine research.

Myth No. 1: HIV vaccines can give people HIV.

HIV vaccines do not contain HIV and therefore a person cannot get HIV from the HIV vaccine. Some vaccines, like those for typhoid or polio, may contain a weak form of the virus they are protecting against, but this is not the case for HIV vaccines. Scientists make HIV vaccines so that they look like the real virus, but they do not contain any HIV. Think of it like a photocopy: It might look similar, but it isn’t the original. In the past 25 years more than 30,000 volunteers have taken part in HIV vaccine studies worldwide, and no one has been infected with HIV by any of the vaccines tested – because they do not contain HIV.

Myth No. 2: An HIV vaccine already exists.

There is no licensed vaccine against HIV or AIDS, but scientists are getting closer than ever before to developing an effective vaccine against HIV. In 2009, a large-scale vaccine study conducted in Thailand called RV144 showed that a vaccine combination could prevent about 32 percent of new infections. Researchers are starting to understand why this vaccine combination worked and how to improve upon it.

Researchers around the world continue to search for an HIV vaccine that is even more effective. Leading this effort is the HIV Vaccine Trials Network, the largest publicly funded group of HIV vaccine researchers in the world. The HVTN is an international effort to find a safe and effective vaccine to stop the spread of HIV. It is funded by the U. S. National Institutes of Health.

Myth No. 3: Joining an HIV-vaccine study is like being a guinea pig.

Unlike guinea pigs, people can say yes or no to participating in research. All study volunteers must go through a process called informed consent that ensures they understand all of the risks and benefits of being in a study, and those volunteers are reminded that they may leave a study at any time without losing rights or benefits. The HVTN takes great care in making sure people understand the study fully before they decide whether or not join. All HVTN research adheres to U.S. federal regulations on research, as well as the international standards for the countries in which it conducts research.

Myth No. 4: A person must be HIV positive to be in an HIV vaccine study.

Not so. While some research groups are conducting studies of vaccines that might be used in people who are already infected with HIV, the vaccines being tested by the HVTN are preventive vaccines. They must be tested on volunteers who are not infected with HIV.

Myth No. 5: Vaccine researchers want study participants to practice unsafe behaviors so they can see whether the vaccine really works.

Not true. The safety of study participants is the No. 1 priority of HIV vaccine researchers and study site staff. Trained counselors work with study participants to help them develop an individual plan on how to keep from contracting HIV. Participants also are given supplies such as condoms and lubricant as well as instructions on how to use them properly. HIV efficacy trials enroll thousands of participants over several years, and with even with the best counseling some participants will still become infected through their risky behavior. Changing human behavior is never easy; after all, many people still smoke, even though it is widely known that smoking is the major cause of lung cancer. An AIDS epidemic would not exist if prevention was as simple as counseling people to change their risky behavior.

Myth No. 6: Now that there are pills that can prevent HIV infection, an HIV vaccine is no longer necessary.

HIV-negative people who are at high risk can take antiretroviral medication daily to try to lower their chances of becoming infected if they are exposed to the virus. This type of therapy – called PrEP, short for PreExposure Prophylaxis – has been shown to be effective among those at high risk. However, it has not yet been recommended for widespread use. PrEP is unlikely to be an option for everyone because the pills are expensive and are not always covered by insurance, may cause side effects, and not everyone has access to them. Remembering to take a pill every day is also challenging for some people. The most effective way to eliminate a disease is by using an effective vaccine. It was a vaccine that eliminated small pox and has almost eliminated polio. Most likely it will be an HIV vaccine that eliminates HIV from the world. Vaccines are an effective, affordable and practical option.

Myth No. 7: An HIV vaccine is unnecessary because AIDS is easily treated and controlled, just like diabetes.

While treatment for AIDS has dramatically improved over the last 30 years, it is no substitute for prevention. Current HIV medications are very expensive, and there are also many side effects. Sometimes people develop drug resistance and have to change the regimen of pills they take. Access to these drugs for the uninsured in the U.S. and those in the developing world is also very limited.

Myth No. 8: The search for an HIV vaccine has been going on for a long time and it’s just not possible to find one that works.

The science of HIV-vaccine development is challenging, but scientific understanding continues to improve all the time. In just the past two years there have been promising results from the RV144 study in Thailand as well as exciting laboratory work, such as the discovery of new broadly neutralizing antibodies against HIV. HIV is a powerful opponent, but scientists are constantly learning from one another and using advanced technology to fight it. Science has come a long way in the 30 years since AIDS was discovered. In comparing preventive HIV vaccine work to other vaccine development, the time it has taken is not so surprising; the polio vaccine took 47 years to develop.

Myth No. 9: Vaccines cause autism and just aren’t safe.

This is not true. Numerous studies in the past decade have found this claim to be false. The British doctor who originally published the finding about vaccines and autism has since been found to have falsified his data. There is actually no link between childhood vaccination and autism. It is true that vaccines often have side effects, but those are typically temporary (like a sore arm, low fever, muscle aches and pains) and go away after a day or two. The value of protection to vaccinated individuals and to the public has made vaccines one of the top public health measures in history, second only to having a clean water supply.

Myth No. 10: People who aren’t at risk don’t need an HIV vaccine.

A person currently may not be at risk for HIV, but life situations can change along with disease risk. Such a vaccine also may be important for one’s children or other family members and friends. By being knowledgeable about preventive HIV vaccine research, a person can be part of the solution by educating friends and family about the importance of such research and debunking the myths that surround it. Even if a person is not at risk, he or she can be part of the effort to find a vaccine that will hopefully save the lives of millions of people worldwide.

To learn more or find out how to get involved in an HIV vaccine study, please visit www.hvtn.org