California is in the midst of a pertussis, or whooping cough, epidemic—and Marin County has the third-highest rate among the state’s 58 counties, according to recent data from the California Department of Public Health. (Sonoma and Napa have the highest and second highest rate, respectively.)
So far this year, Marin’s 135 cases have set the county’s rate at 52.76 cases per 100,000 people, almost six times as high as the state’s overall rate. Two infant deaths in California this year have been attributed to pertussis, a bacterial infection that seems like a mild cold at first but turns into painful, violent coughing fits that end with a signature whooping sound, and in severe cases can last for months. (In China, it is called the 100-day cough.)
The last outbreak in California occurred in 2010; that year, Marin had the highest rate in the state. Though outbreaks tend to occur every three to five years, the number of overall cases has been on the rise since the 1990s.
That’s in part because the modern version of the pertussis vaccine is less powerful and requires more boosters to remain effective. (The old version was replaced because it caused more side effects.)
Marin likely has one of the highest rates because a contingent of parents chooses not to vaccinate their children; in the fall of 2013, only about 80 percent of kindergarteners in Marin had all their immunizations, one of the lower rates in the state and below a generally recognized threshold that would offer “herd immunity.”
When enough people are vaccinated, infections have fewer opportunities to gain a foothold; that rate can vary among different infections but for pertussis it’s around 92 to 94 percent, according to the Center for Disease Control.
But some parents—fearing additives or just suspicious of the pharmaceutical industry as a whole—shun vaccines.
“I do understand that our patients who don’t immunize have their own rationales and that they don’t just accept what the doctor says…That’s not something we judge in a negative way, although I don’t agree,” said Mike Witte, the medical director at the Coastal Health Alliance.
Among children and adolescents, rates of pertussis this year are higher among Anglos than Latinos, Asian Americans or African Americans.
Wendi Joiner, a doctor at the health alliance, said they’ve seen an increase of cases here in West Marin this year, and she cautioned parents who believed it would be better to risk their kids getting whooping cough than take the vaccine. “You can have permanent lung damage. The idea that it’s better to get the infection than the vaccine is not appropriate… If you don’t vaccinate you’re making a bigger decision than you realize. It might be you that transmits the bacteria that gives it to a six-month-old,” she said.
The health alliance encourages children and their caregivers and others in regular contact with youth to ensure their immunizations are up to date.