Whooping cough outbreak closes health center

What is pertussis?

Pertussis is a very contagious respiratory illness, also known as whooping cough. It’s caused by the Bordetella pertussis bacteria and can be spread from person to person by coughing or sneezing near others who then breathe in the bacteria.

Signs of pertussis

• Runny nose

• Low-grade fever

• Intially mild, occasional cough

• As the disease progresses, rapid coughing, followed by a high-pitched “whoop,” vomiting or exhaustion.

• In infants, a pause in breathing, or apnea.

Treatment

• Antibiotics

• Keep your home free of irritants that trigger coughing, such as smoke, dust and chemical fumes.

• Vaporizer will help to soothe cough.

• Drink plenty of fluids, including water, juice and soups and eating fruits to prevent dehydration.

• Report any signs of dehydration to your doctor immediately.

• Eating small, frequent meals to prevent vomiting.

Source: Clark County Combined Health District

Clark County faces a "community outbreak" of pertussis, or whooping cough, including dozens of suspected cases and one confirmed case inside a health center, according to local health officials.

The Rocking Horse Community Health Center, 651 S. Limestone St., was closed Friday and will be closed today after a female employee was diagnosed with the illness on Friday morning.

The cases may not have peaked, Patterson said, although he'll have more information on the status of the cases Monday.

"We haven't seen a downturn yet," Patterson said.

The cases would represent a "significant increase" in yearly activity for Clark County, if confirmed.

In 2011, the health district investigated 10 cases of pertussis. Last year, 15 cases were investigated, eight of which were confirmed. Twelve cases in Clark County were confirmed last July.

Dr. Yamini Teegala, family physician and medical director for the Rocking Horse Center, said the facility was closed early Friday morning after an employee was diagnosed with a positive case. The center immediately contacted the health district, which sent personnel and began treating approximately 140 employees and at-risk family members who may have been exposed to the disease.

"They've been out in front from the start," Patterson said.

They're also in the process of calling patients who may have been exposed to the disease, but Teegala couldn't estimate how many people may have been exposed to the disease.

The Rocking Horse Center, which opened in 1999 to provide medical care to underserved children, has approximately 56,000 visits per year. Rocking Horse has expanded to four locations in which it serves 13,500 people of all ages and recently became a Federally Qualified Health Center. The center recently opened a $7.9 million expansion at its South Limestone location in April.

The disease is caused by the bacteria Bordetella pertussis and, as the disease progresses, causes rapid coughing followed by a high-pitched "whoop," vomiting and exhaustion, according to to the health district.

Pertussis is spread through airborne particles from coughs and sneezes to other people who breathe in particles in close proximity. Other symptoms include runny nose, low-grade fever, mild, occasional cough and apnea — a pause in breathing — in infants.

"It's a nuisance," Patterson said. "To get well, they're probably going to need antibiotics."

Young children, particularly infants, have a difficult time controlling the cough so they can breathe regularly, Patterson said. In rare cases, it can cause complications and even death.

"We're trying to get out in front of this and stop anything bad from happening," Patterson said.

With so many cases in Clark County, Teegala said it's hard to determine how the disease arrived inside the facility. However, the employee may have come in contact with a child with pertussis.

Last week, the health department released a memo to local doctors about an increase in pertussis cases in Clark County. Springfield City Schools also called students to make them aware of the signs and symptoms of the disease.

"This additional case at the center is on the heels of the recent cases we've seen in the community," Patterson said. "The actions they've taken have helped us to contain the illness in the community."

Patterson said Rocking Horse went "over and above" following the Center for Disease Control, Ohio Department of Health and local guidelines when dealing with an employee with pertussis.

Prevention includes the vaccination of all ages, starting with infants. Teegala said the outbreak shows the importance of receiving childhood immunizations, which includes five doses by the age of five and a booster dose for children ages 11 to 12.

Teegala was unsure if the employee had received those immunizations. The center may study the confirmed cases to see if those patients had received all of their vaccinations, Teegala said.

Patterson said they've seen cases where people who had received all of their vaccines still contracted the disease. The vaccines aren't 100 percent effective, Patterson said, and some of the subcategories of the disease may not be covered by the vaccines.

Patterson said residents with pertussis symptoms must seek medical attention because the correct antibiotics are needed.

"If they're misdiagnosed as bronchitis, which is typical, they may have to go back and get the correct antibiotics to take care of the pertussis bacteria," Patterson said.

Rocking Horse Center patients with other medical illnesses today will have access to the on-call physician or nurse practitioner, who will be able to help patients by phone. The center will reopen on Monday at 8:30 a.m.

"We can actually triage their phone call and see how the child is doing and properly guide them on what to do," Teegala said.