Licensed practical nurse Debra Poe gives a tetanus, diptheria and pertussis immunization shot at the Pima County Health Department office on East Broadway. There have been 69 cases of whooping cough reported in the county this year, up from 46 last year. 

Three confirmed cases of whooping cough at a Vail high school have prompted drastic action by the Pima County Health Department.

The latest cases bring the total of reported student whooping cough infections in the Vail Unified School District east of Tucson to seven. Four cases were reported at the district’s Sycamore Elementary School, Rincon Vista Middle School and Civano Community School between early September and the beginning of October.

A total of 69 cases of whooping cough have been reported in Pima County so far this year, which exceeds the total of 46 for all of last year.

County health officials say any Empire High students who have not been vaccinated against whooping cough should not be allowed to attend classes or school-related activities for three weeks or longer, depending on whether future cases are identified.

The order was issued over the weekend by Dr. Francisco Garcia, director of the Pima County Health Department. It’s the first time since Garcia began his job in January that he’s taken such action, which is allowed under state law. It was necessary because the three cases occurred close to one another — the most recent was reported Friday.

The parents or guardians of six students at Empire High School have signed a waiver exempting their children from vaccinations, Garcia said Monday. Another 14 students have not had their full series of vaccines against pertussis, he said.

“There are always going to be people who have very strong personal, deeply held beliefs,” Garcia said. “We have to err on the side of protecting the health of Pima County.”

Families called

The Empire students who fell ill had been vaccinated and showed milder symptoms than children who haven’t been vaccinated, said Vail Assistant Superintendent of Special Projects John Carruth.

Empire Principal Matt Donaldson and his assistant principal spent the weekend calling families of students whose records showed they had not received a vaccination for whooping cough, he said. Of Empire’s 760 students, they contacted 25 families and found 14 students who still hadn’t received a vaccination or needed a booster shot, Carruth said.

Students who receive a vaccination can return to school 14 days later, the Health Department said. Those who don’t should stay home for 21 days, beginning last Friday, when the three cases were confirmed, the Health Department advised. That could change if more cases are reported.

Empire is working on an arrangement to let students who have been pulled out of school attend class through a live video chat at one of the district’s sites, Donaldson said.

“There’s definitely a concern about what’s going to happen in regards to keeping up with classes,” he said.

Despite the uncertainty, Donaldson called parents’ response “extremely positive and supportive. The parents have been great,” he said.

Vail isn’t the only district that has seen whooping cough lately.

The Tucson Unified School District, with 50,000 students, has confirmed four cough cases this school year — three at high schools and one at a middle school, said Janet Lew, the district’s immunization and epidemiology resource.

Two of the high school cases were at the same east- side school, and letters were sent to parents, Lew said. She said there was a probable case of whooping cough at a district elementary school as well.

Still, the numbers this academic year so far seem to be lower than last year, she said. “There is pertussis in the community — it’s a given.”

Cases up statewide

Statewide, confirmed and reported cases of whooping cough, also called pertussis, jumped 438 percent between 2007 and 2012.

A higher than average number of cases have been reported in Mohave County this year, around Colorado City near the Arizona-Utah border.

“Certain pockets throughout the state don’t like vaccines as well,” said Dr. Karen Lewis, medical director of the Arizona Department of Health Services’ Immunization Program Office. “The parents are afraid of vaccines, about the incorrect rumors about autism and brain damage. They want their children to be protected, but they just have the wrong information.”

Nationally, 48,277 cases of whooping cough were reported last year, which is the highest number reporter in the U.S. since 1955.

Health officials attribute the spike to a combination of factors. Fewer parents are vaccinating their children, and more are starting but not completing the series of vaccinations. The vaccine is effective only about 70 percent of the time. And a switch from what’s called a “whole cell” pertussis vaccine to a more purified “acellular” version appears to be causing the childhood pertussis vaccine to wear off faster than in the past.

In a letter to Vail Assistant Superintendent Carruth, the Health Department’s Garcia said he decided to take several disease-control measures at Empire High School because the disease is potentially fatal, particularly for anyone with a weakened immune system.

Students with an abnormal cough should stay out of school until they are evaluated by a primary-care provider, Garcia wrote.

“We’ve been working with the school district on a daily basis. They knew they were close to being called an outbreak,” Garcia said. “Vail School District has been awesome, and we’ve been having really good communications with them.”

In Arizona, whooping cough tends to have a surge every three to five years, but with the vaccine not lasting as long, the number is going to rise, Lewis said. Also, the number of parents seeking exemptions for their children in child-care centers and school has doubled in the last 10 years, Lewis said.

She said jurisdictions from time to time exercise their right to keep unvaccinated kids at home to prevent outbreaks.

It’s necessary to protect babies who are too young to be vaccinated and children with compromised immune systems, who can get sick even if they have been vaccinated, she said.

“Think of all those parents whose children are at risk because unimmunized children, teenagers may be spreading disease,” she said. “They may take it home to some family where there is an infant who will die from it.”

Star reporter Alexis Huicochea contributed to this report.