TB and Whooping Cough On Rise in Montgomery County

Whooping Cough has tripled this year in Montgomery County, while tuberculosis is continuing a steady climb that is twice as high as rates seen across the state and the rest of the country.

While Montgomery's surge in whooping cough paralells a national trend, the prevalence of tuberculosis stands out against declining state and national figures, the county health officer told the County Council on Tuesday.

Whooping cough—known medically as pertussis—is caused by a highly contagious bacterium and can be deadly for infants.

Alarms of a nationwide epidemic sounded this summer when the Centers for Disease Control announced pertussis rates that were on pace to be the worst since 40,000 cases were reported in 1959, ABC News reported. The outbreak has been most acute in Washington state, which is seeing 10 times more whooping cough than last year, the Seattle Times reported.

Investigations and confirmed cases of the disease in Montgomery County have more than tripled from last year, said Dr. Ulder Tillman, director of the county's Department of Health and Human Services.

In 2011, DHHS investigated 24 cases overall, 18 of which were confirmed or deemed probable. This year has brought 90 investigations, nearly 60 of which have been confirmed or deemed probable.

“We are seeing striking rises in the cases and investigations," Tillman said. "… We’ve got to do something to stem these increases.”

While the disease is more common among infants and young children, “it has been increasing among our teen and adult populations” in Montgomery County, she said.

Typical protocol had been to vaccinate for pertussis whenever someone is vaccinated for tetanus. Tillman said the recommendation now is to administer booster shots for 11- and 12-year-olds and for anyone in households with infants 12 months old or younger.

While there is a test for detecting the disease, health care providers don’t usually think to use it, Tillman said. DHHS needs to urge health care providers to be more on the lookout, she said.

Montgomery County is also seeing an uptick of tuberculosis, a bacterial disease that attacks the lungs and can spread to the spine and brain.

Montgomery’s rate continues to be nearly twice the state and national norm, Tillman said:

• Montgomery County - 7.6 cases per 100,000 residents
• Maryland - 4 per 100,000
• Nationwide - 3.6 per 100,000

There were 73 cases of TB last year, Tillman said. So far, there are 14 percent more active cases this year than last.

“This is really basically because of the demographics of our county," Tillman said. "We have one-third of our population foreign-born. They come from countries that have very common tuberculosis, so they bring that with them.”

Councilwoman Nancy Navarro said she wants to urge County Executive Isiah Leggett to use the county’s public information office to create a campaign targeting ethnic populations and “keep it fresh in people’s minds.”

Meanwhile, Tillman cautioned the County Council about the specter of cuts in federal aid.

“If you’ve got falling cases rates of tuberculosis in the nation as well as in the state, you may think that that is the very area that you can save money," she said. "Whenever we cut in this area, then we see a rebound effect. … We do not want to reduce resources and support to this area.”

Tuesday’s briefing also covered West Nile virus and Lyme disease.

West Nile—the mosquito-borne virus that first surfaced in the United States in 1999—has not hit Montgomery County as hard as it has the rest of the country, which this summer saw the worst outbreak yet, CNN reported.

A disproportionately low number of Maryland’s 41 cases of West Nile through the end of October—two of which resulted in death—have come from Montgomery. The county has seen only two cases of West Nile this year, compared to four last year, Tillman said.

Lyme disease—which causes fever, headache, fatigue and can eventually impact the heart and nervous system—is continuing its rise in Montgomery County.

Montgomery County saw more than 1,000 cases in 2010. That jumped to nearly 1,400 last year. So far this year, 1,407 county residents have contracted the disease, Tillman said.

Exposure to the deer-born ticks that transmit the disease will continue to be an issue this year “until we get a good hard frost,” Tillman said.