12/15/13 12:00pm
12/15/2013 12:00 PM

A new FDA study could help explain the re-emergence of whooping cough, a contagious disease that has claimed the lives of more children than scarlet fever, diphtheria or measles during its height, according to the Centers for Disease Control and Prevention.

48,000 cases of pertussis were confirmed nationally last year, resulting in 20 deaths, according to the FDA report.

The East End is hardly immune, as cases of pertussis have been reported in the past month at both Riverhead High School and the district’s Pulaski Street School, according to school officials. The number of cases was not disclosed.

Several cases of whooping cough have been confirmed each year since 2011 — and possibly earlier — not only in Riverhead but in the Shoreham-Wading River, Southold and the Mattituck-Cutchogue school districts as well.

The FDA study, published Nov. 25, showed that the while the current vaccine for the pertussis prevents adults and children from contracting the illness themselves, it does not prevent people from becoming colonized with the bacteria that causes it – Bordetella pertussis.

And those who are colonized can pass on the bacteria – infecting others, particularly infants not yet fully immunized, the study found.

“[The vaccine] is not protecting us to the full degree. It is protecting us from not developing clinical symptoms but it doesn’t protect us from being carriers,” said Dr. Yuliya Vinnitskaya, a new internal medicine physician at East End Physician Services in Southold. “Those vaccinated can carry the bacteria in airways for up to six weeks and spread it to infants.”

Pertussis starts out with typical cold symptoms that slowly become more severe, eventually manifesting with spells of rapid, violent coughing followed a “whooping” sound as patients try to take a breath, according to the CDC.

Those infected can spread the bacteria while they are suffering from the cold-like symptoms and for about two weeks after the coughing starts. Infection develops 7 to 10 days following exposure to the bacteria and symptoms can last for up to three months.

Dr. Vinnitskaya said the FDA’s recent findings call for the development of a new vaccine.

The current vaccine is what’s known as an acellular vaccine – which only contains portions of the pertussis bacteria. The FDA approved it in 1991, replacing its predecessor, which contained dead, but complete, forms of the bacteria. Dr. Vinnitskaya said.

The FDA is also investigating the possibility of diminished immunity from childhood pertussis vaccines, which it says may also play a role in re-emergence.

Infants begin immunizations for the disease starting at two months old – receiving a series of five shots – but they do not achieve full immunity until their last shot, which is given between ages 4 and 6, according to the CDC. Preteens and teens also receive a booster shot between the ages 11 and 18.

Dr. Vinnitskaya said infants are most likely to contract the disease from a loved one, so parents, grandparents and even siblings need to be extra cautious around young children.

Should someone come in contact with an infected individual and develop cold-like symptoms, she recommends they visit their physician.

And, of course, lots of hand washing is essential. It’s also flu season, after all.

Got a health question or column idea? Email Carrie Miller at cmiller@timesreview.com.

fda

05/19/13 7:30am
05/19/2013 7:30 AM

BARBARAELLEN KOCH FILE PHOTO | Farmer Phil Schmitt (left) and his sons Matt (center) and Phil Jr. loading boxes of cabbage onto a flatbed at the family’s Riverhead farm in 2011. Phil Schmitt says most food safety issues have come out of West Coast and large farm operations.

North Fork farmers are facing new government regulations they say will lead to too much paperwork — only to fix a problem that exists elsewhere in the U.S.

The new regulations, part of the federal government’s Food Safety and Modernization Act of 2011, aim to protect U.S. consumers from contaminated food products by improving produce production and packaging safety. The regulations pertain mostly to water quality monitoring, worker training and cleanliness. They also require documentation that farmers are meeting these standards, as well as daily record-keeping of activities on the farm. The idea, according to the FDA, is that during an outbreak of food-borne illness, the records could help determine the source of the food involved.

But local farmers say all the large outbreaks of food-borne illness from U.S. produce is related to food grown elsewhere in the country.

“A lot of these issues that have come up over the years have been from the West Coast or very large growers — far from what I consider a family farm,” said Phil Schmitt of Schmitt Family Farm in Riverhead. “They have huge facilities where they produce more in two hours than I produce all year. Meanwhile, we have the same type of regulation after us.”

“I’ve been here for 25 years and I have never heard of any situation as a result of Long Island produce,” said Long Island Farm Bureau executive director Joe Gergela. “We’ve never had an outbreak.”

Before the new regulations were drafted, 14 FDA officials toured three North Fork farms in August 2011 to see how local farms were run.

“We showed them what the impact would be on small farms and the practicality of such regulations,” Mr. Gergela said. “We’re a bit disappointed.”

Of all the regulations, the documentation process will likely have the biggest effect on local farmers.

“All the growers are practicing so many aspects of food safety, they are just not documenting them to the extent that this new rule is going to make them,” said Sandra Menasha, a Cornell Cooperative Extension educator who trains local farmers to meet the new regulations.

Growers are going to need to be able to trace back every product that leaves their farm to the field where it was harvested, down to the hand that picked it, Ms. Menasha said. She has a 70-page document listing the different types of records growers will need to keep, which include daily temperate readings of refrigeration units, dates and times equipment is cleaned and sanitized and lists of visitors to the farm.

“We’re trying to keep up with everything but it’s getting harder,” said John Kujawski, a potato farmer in Riverhead. ”With all the stuff we have to do, it’s almost like we have to get a full-time secretary here.”

One upside to the new law is that some small farms will be exempt from the regulations. Farms with an average annual income of less than $500,000 for the past three years, which sell more of their products direct to consumers than to other distributors, would be considered exempt, according to the act.

Many area farms, however, do not qualify for the exemptions. Ms. Menasha estimates that about half of the North Fork’s farmers will still have to deal with the new regulations.

Depending on the size of the farm, the FDA estimates it will cost farm owners between $5,000 and $30,000 annually to comply with the new regulations.

Lyle Wells, whose family has been farming in Riverhead for centuries, said it would probably cost him $30,000 to hire someone full-time to handle the documentation alone, aside from all the other requirements he will have to meet.

“On top of the increased cost of production — fertilizer, fuel, the increased burden of environmental stewardship — the record keeping and regulations make it harder for our farmers to compete , not only on the world market but the U.S. market,” Ms. Menasha said. “We’re all small family-run farms,”

These new food safety regulations are still up for debate, as the FDA will be accepting comments on them through Sept. 16, a 120-day extension from its original deadline of May 16.

Comments can be submitted electronically at www.regulations.gov  or mailed to Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Room 1061, Rockville, MD 20852.

cmiller@timesreview.com