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.

Photo: Sanja Gjenero

The  Puget Sound Clean Air Agency has issued a Stage 1 burn ban for King, Kitsap, Pierce and Snohomish counties, as a high-pressure system brings cold temperatures and calm winds to the region and creates conditions that can trap smoke from wood fires and other air pollutants.

Under the ban the use of fireplaces and uncertified wood stoves is prohibited until further notice.

Air quality is expected to worsen at least through Friday, especially in communities where residential wood burning is common, Clean Air Agency forecasters said.

Air pollution can trigger asthma attacks, cause difficulty breathing, and make lung and heart problems worse.

Air pollution is especially harmful to people with lung and heart problems, people with diabetes, children, and older adults (over age 65), the agency warned.

The Washington State Department of Health recommends that people who are sensitive to air pollution limit time spent outdoors, especially when exercising.

Photo by Sanja Gjenero

During a Stage 1 burn ban:

• No burning is allowed in fireplaces or uncertified wood stoves. Residents should rely instead on their home’s other, cleaner source of heat (such as their furnace or electric baseboard heaters) for a few days until air quality improves, the public health risk diminishes and the ban is cancelled.The only exception is if a wood stove is a home’s only adequate source of heat.

• No outdoor fires are allowed. This includes recreational fires such as bonfires, campfires and the use of fire pits and chimineas.

• Burn ban violations are subject to a $1,000 penalty.

It is OK to use natural gas, propane, pellet and EPA certified wood stoves or inserts during a Stage 1 burn ban.

(Note: The Seattle Parks Department prohibits beach fires at Alki and Golden Gardens during air quality burn bans.)

How to tell if a wood stove is certified, and OK to use during a Stage 1 burn ban?

Age matters – if the stove is over 20 years old, it is likely uncertified and prohibited for use during a burn ban.  Uncertified wood stoves are no longer legal to sell or purchase in the State of Washington due to the significant pollution they generate.  A certified stove will have an EPA label on the back.

For more information:

• Updated air pollution data and forecasts

• Frequently asked questions about burn bans

November through March winter weather often causes stagnant air that traps air pollution from outdoor burning, wood stoves, and fireplaces gets trapped near the ground, officials said.

Who is at highest risk?

Breathing polluted air can cause short and long-term health problems. People with heart and lung diseases are more likely to develop serious health problems. Sometimes, older adults have heart or lung disease that they’re not aware of, and it puts them at risk. Kids spend more time outside, where they’re exposed to air pollution for longer periods. Children’s lungs are more easily damaged because they’re still developing.

Exercise and air pollution:

When air quality is poor, people should limit outdoor activities and reschedule them for a time when air quality is better. When people exercise, they breathe more air and air pollution into their lungs. If you decide to exercise, choose a less strenuous exercise such as going for a walk instead of a run. And avoid exercising in higher pollution areas such as near highways or in neighborhoods with a lot of wood smoke.

How to check air quality

Be sure to check air quality (http://www.airwatchnw.org) before heading out for outdoor activities, especially if you’re in a high-risk group. Often air pollution can’t be seen or smelled, so it’s hard to judge air pollution levels.

Burn bans:

Several burn bans have been issued across the state recently because of poor air quality. Smoke contains fine particles and toxic gases that can be breathed deep into lungs. Some counties in the state are under a burn ban. Before you burn, check to see if your county is under a burn ban (www.waburnbans.net).

To learn more:

• More information about how air quality can affect your health (www.doh.wa.gov/ehp/smokefactsheet.pdf) is on the Department of Health website.

Mildew from a wooden soap dish - Photo by Bob Baylock

By Glenda Fauntleroy, Contributing Writer
Health Behavior News Service

A new evidence review finds that ridding homes and offices of mold and dampness can help reduce respiratory infections and troubling symptoms for asthma sufferers across the globe; however, the best way to eliminate the mold remains unclear.

Mold is one of the most important environmental triggers of symptoms such as coughing and wheezing, according to National Institute of Environmental Health Sciences.

“Mold is found in many homes with basements, in apartments and walkouts that are partially or fully below ground, and in buildings that have been flooded or have poor humidity control,” said Peter Thorne, head of the occupational and environmental health department at the University of Iowa. “Homes and office buildings alike have problems.”

But does “remediating” or relieving homes, offices and schools of dampness and mold make a big difference? Lead reviewer Riitta Sauni at the Finnish Institute of Occupational Health in Tampere, Finland, said that results are mixed.

PHOTO: Bob Baylock under Creative Commons license

Key Points:

• Ridding homes and office buildings of mold can reduce the incidence of respiratory illness and decrease asthma-related symptoms, a new Cochrane review finds.

• While removing mold from offices and homes can reduce coughing and wheezing, the best method for mold removal remains to be determined.

• Mold can be costly to remove from buildings, which can be re-infected even after cleaning and fungicide treatments.

“We were happy to find evidence that remediation of mold-damaged houses decreased the severity and amount of symptoms in patients with asthma and respiratory infections,” Sauni said. “Unfortunately, we did not find evidence that remeditation could prevent these diseases.”

The review appears in the September issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

Remediation of mold and dampness requires total or partial renovation of a building, or cleaning with a fungicide or bleach solution. Sauni and her team looked at eight studies with 6,538 participants who had their homes, schools or workplaces remediated by a mixture of these methods.

The reviewers say that because the available studies did not offer high-quality evidence and sample sizes were small, “drawing hard conclusions was difficult.”

Nonetheless, the review found that when compared to doing nothing at all, repairing houses decreased asthma-related symptoms as well as the amount of respiratory infections in adults.

Remediation also decreased the number of acute care visits in children and students’ visits to physicians for common colds.

In one South Wales study, for instance, 115 members of the group who had their homes remediated with the complete removal of visible mold, a fungicide treatment and installation of a fan, were more likely to see improvement in their respiratory symptoms for six and 12 months afterwards, compared to those in the control group whose homes were not cleaned.

The reviewers, however, could not determine which method of remediation was superior to significantly improving asthma symptoms.

“The studies have shown that after cleaning and fungicide treatment, a large number of the buildings were soon re-infected with molds, and also a partially remediated office building had to be repaired more thoroughly,” Sauni said, adding that mold removal can be costly.

“Sometimes, if the structures are damaged widely, the easiest and most cost-effective possibility is to pull down the damp building and build a new one,” she said.

The reviewers concluded that better research is necessary to give evidence of improved outcomes.

Health Behavior News Service is part of the Center for Advancing Health

The Health Behavior News Service disseminates news stories on the latest findings from peer-reviewed research journals. HBNS covers both new studies and systematic reviews of studies on (1) the effects of behavior on health, (2) health disparities data and (3) patient engagement research. The goal of HBNS stories is to present the facts for readers to understand and use for themselves to make informed choices about health and health care.

In the report, called the Annual Fitness Index, the College ranks cities on a variety of measures including the preventive health behaviors of its citizens, levels of chronic diseases, access to healthcare, and community resources and policies that support physical activity.

Photo by Bufferchuck

Compared to national averages, Seattle residents were more likely to to have exercised, to have eaten five servings of fruit and vegetables per day, and to have walked, biked or taken public transportation to work.

And Seattle residents were also less likely to smoke, 13.3 percent vs. a national average of 17.9 percent.

Like other top ranked cities, the Seattle region tended to be better off with a higher median household income, lower percentage of households below the poverty level, and fewer unemployed.

The area also has more primary care providers per capita than average metropolitan area in the study, lower rates of diabetes, asthma, and coronary artery disease.

Where the region fell short, the report finds, was in access to amenities that can promote physical activity, having fewer acres of parkland, golf courses, recreation centers and pool per capita than average.