Varicella, pertussis outbreaks severe in year-end health report
By Dave Mast
February 25, 2010
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The year 2009 may have been fraught with outbreaks of H1N1, varicella (chickenpox) and pertussis (whooping cough), but despite huge increases in chickenpox and whooping cough, Holmes County was in good shape from a health standpoint. During a discussion at the monthly health district board meeting, Vaughn Anderson, health department epidemiologist, discussed the year-end 2009 reportable diseases, noting that the two main focal points were on pertussis and varicella.
It was a very interesting year, to say the least, because we had several outbreaks of pertussis occur at the same time the H1N1 scare was hitting us hard, said Anderson.
Holmes County had 166 cases of state-reportable Class A and Class B 1-2 diseases during 2009, a massive 82.4 percent increase from the 91 cases reported in 2008. Anderson said that large increase was due largely to pertussis and varicella, which increased from 25 reported cases in 2008 to 51 last year, while pertussis increased from an average of one or two cases each year for the past five years to 51 in 2009. Anderson said that the numbers were due to massive cluster outbreaks throughout the state.
These outbreaks took place in our county over a six-month period of time, and not just as one large outbreak, said Anderson. Other than these two, most of the communicable diseases remained fairly steady and consistent compared to prior years.
Holmes County actually led the investigation of one outbreak that encompassed several states, and occurred during a youth camp in Holmes County. In that instance, approximately 40 youth and five adults attended the camp, with 15 becoming ill and three seeking medical attention. E. coli was confirmed in only one of the youth.
The county got a clean bill of health from its restaurants, with none being reported as the cause of any kind of communicable disease outbreaks; however, several churches and schools were central to outbreaks of pertussis and varicella. In addition, Holmes County had two cases of H1N1 reported in 2009, although numerous patients were treated for H1N1 flu-related symptoms which were never verified.
Anderson said that the health district personnel did a phenomenal job of both treating and educating the public concerning H1N1, pertussis and varicella, especially during the many H1N1 clinics it provided throughout the year.
He noted that one statistic which changed greatly between 2008 and 2009 was the average number of days it took for patients suffering from pertussis to report their disease from the time they actually contracted it.
In 2008, the number of days from the onset of the disease to the reporting day was 36.98 days in length, more than one month between when people were getting pertussis and reporting it to the health district. In 2009, that number shrunk to 16.1 days, and Dr. D.J. McFadden, health commissioner, said that movement resulted from several factors.
Obviously, the outbreak of pertussis in the county played a major factor, said McFadden. When the fear is real, people are more apt to report it when they suffer from symptoms. But I also think we did a good job as a whole in educating and increasing awareness that pertussis is not a disease to mess around with. I think, too, that the scare of H1N1, and people not being sure what those symptoms might be, may have driven people to report sooner.
Despite the drop in days waited to report, Anderson said that he would like to see that number come down even further, as the county will undoubtedly battle pertussis again.
We would ideally like to see that number drop to below 14 days, said Anderson. Its kind of tough to report it really early on because the symptoms are much like that of the common cold at the onset.
Anderson also reported that Holmes Countys seasonal peaks for H1N1 were generally one week later than the national seasonal average. That, he said, was a blessing for the county as it prepared to fend off the flu.
By lagging behind the national average, we were able to get the word out to physicians and to prepare ourselves for H1N1,said Anderson. It worked out well because it gave us a bit of a warning before hitting us here.
