Student cases of disease increase

Friday, May 21, 2004 | 12:00 a.m. CDT; updated 10:01 p.m. CDT, Tuesday, July 1, 2008

Whooping cough continues to works its way through the Columbia Public School District.

Nine cases have been confirmed throughout the district, with six cases reported at Smithton Middle School. The most recent case was confirmed Thursday at Gentry Middle School, the school’s first case.

Regardless of the outbreak, said Mary Martin from the Columbia/Boone County Health Department, the department is not considering any school closures.

“There’s no reason they can’t be going to school,” Martin said. “There’s no point in closing when you have a few kids testing positive.”

At Gentry, the first wave of letters explaining the situation were sent home with students Thursday in what the Health Department refers to as a ring treatment. School nurses are contacted, then it’s up to the school to distribute the letters. There are two types of letters, a general letter stating there has been a diagnosis and another if the student has had a close contact with the diagnosed — this is based on the student’s schedule such as class, lunch and bus. The Health Department gathers necessary information from parents regarding the infected student’s extracurricular activities and playmates, then directly calls those who were at a higher risk and more likely to have been exposed.

“(The Health Department) is not aware of how far this ring went,” Martin said. “Children are very mobile.”

The first two cases, a student from Grant Elementary and a student from Smithton Middle, were tested May 8. The next five cases were students from Smithton who tested May 12. The next case was a student from Russell who was not tested, but clinically diagnosed May 14. The most recent case, a student at Gentry, was tested May 18.

The Medical Director at Columbia/Boone County Health Department has been dealing with some physicians who initially refused to prescribe preventative antibiotics.

“My son is a student at Paxton Keeley Elementary School, but is good friends with a student at Smithton, who is on antibiotics as he was exposed to the student with whooping cough,” Larry McKinley wrote in a letter to the Missourian. “My wife and I contacted our doctor’s office at University Physicians and they wouldn’t prescribe antibiotics. We were told that they wouldn’t unless symptoms appeared, which to my understanding is too late for antibiotics to help.”

Nationally there is a trend not to over-prescribe as diseases are forming defense mechanisms and strains resilient to antibiotics, according to Jeff Hoelscher, Senior Information Specialist, University Missouri Health Care.

Dr. Michael Cooperstock, of Infection Control at University Hospital, said there is room for physician judgment when prescribing antibiotics for whooping cough. But if the child has had direct contact with an infected person within the 6 to 21 day incubation period and shows symptoms, they should be treated. Additionally, if they are in the same household as an infected, with or without symptoms, they should be treated.

Columbia Public Schools Superintendent Phyllis Chase said the decision to treat children with antibiotics rests with the parents, but if they do not, the children will be excluded from school. She said there’s a “high chance” the school district will see more cases of whooping cough before school ends June 3.

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