Health & Welfare | Daily Report

Flickr photo by Anders Adermark

Preliminary data from state public health officials show that the state’s richest and one of its poorest counties are leaders in the number of whooping cough cases, as cases of the illness are mounting to epidemic proportions. (See the data in a spreadsheet below.)

The reasons for the apparent trend are surprising.

As I’ve documented here, Fresno often stands out in measures of a vulnerable population gripped with child poverty and other ills.

The opposite is true of Marin, a county often voted among the nation’s fittest.

So what’s going on? Parents in Marin County are citing “personal belief” and signing waivers to opt out of immunizing kindergarten-bound children, said Dr. Fred Schwartz, the county public health officer. The practice is highly controversial and driven by fears (many debunked) that vaccinations can cause more harm than good.

Schwartz said 7.1 percent of kindergartners enter school without shots, among the highest rates in the state.

"It's not as a sole explanation, but probably a contributing factor," said Schwartz, who recommends immunization.

He said 97 of the 183 cases in the county are among elementary school students, though many are among children old enough to have seen their first whooping cough vaccination wear off after three to five years.

The California Department of Public Health released county-by-county numbers of whooping cough cases to California Watch yesterday, cautioning that local delays in reporting underplay the reach of the epidemic. Spokesman Ken August said counties such as Los Angeles and Ventura certainly have more cases than have been officially reported.

The numbers currently used by state officials show that Fresno leads the state in the number of confirmed cases of the illness, with 145. Marin comes in second, with 119 cases. (The Marin local number is higher, likely reflecting a delay in reporting.)

The chart below contrasts the number of cases from the start of 2009 to June 15 with the number of cases confirmed this year. Statewide, the number of cases has increased more than fourfold, from 219 cases by this time last year to 910 this year. The state's public health director characterized the trend as an "epidemic" on track to surpass levels of the illness not seen since 50 years ago.

California Department of Public Health spokesman Ralph Montano said the five deaths linked to the illness were in Fresno, Stanislaus, San Bernadino and Los Angeles counties, with LA reporting two deaths. Officials are reviewing reports of an additional 610 cases.

The Associated Press reports the illness has not been a significant threat in the state since 1952, when it killed 15 people in California. The Los Angeles Times published a graphic in late May that puts the lifespan of the illness in perspective. The illness peaked in 1934 with more than 260,000 cases nationwide.

By 2009, that number fell to a mere 5 percent of the Depression-era tally, with 13,500 cases.

Here's how Department of Public Health officials describe whooping cough, also known as pertussis: "A typical case of pertussis in children and adults starts with a cough and runny nose for one to two weeks, followed by weeks to months of rapid coughing fits that sometimes end with a whooping sound. Fever is rare."

Authorities are urging parents of children younger than one to get a vaccination, as well as children and teens.

The following data supplied by the California Department of Public Health shows the number of cases reported in 2009 and 2010, as well as the rate of cases per 100,000 residents in each California county: