Detroit Suburbs at Heart of Michigan's Whooping Cough Outbreak

Michigan has reported 1,305 cases of whooping cough to the Centers for Disease Control through Dec. 4, according to the CDC's latest report. The Michigan Department of Community Health releases data on reportable illnesses in the state on a weekly basis, and the latest report from MDCH is also through Dec. 4. The data are listed by county.

Working with the data and a public domain Michigan county map, a pattern emerges when pertussis case counts are displayed. The heart of the outbreak is in the southeastern part of the state, and lies in those counties surrounding the City of Detroit and west to Washtenaw County and Ann Arbor.

Washtenaw County presently has reported 191 cases of whooping cough in 2010. That is the highest county total in the state. Genesee and Oakland Counties follow with 111 cases each. There is a small cluster of cases in the Grand Rapids vicinity and the two counties due west. The only true outlier is Houghton County in the Upper Peninsula of Michigan, which has reported 76 cases.

The Census Bureau estimates that the median household income in Michigan in 2008 was $48,606. Washtenaw County had a median income for the same year of $59,126. Oakland County's was $67,669. Macomb County, reporting 56 pertussis cases, had a median income of $55,638. Livingston County has reported 96 cases and its median income was $72,090.

Ann Arbor, in Washtenaw County, is the home of several colleges and universities, including the University of Michigan.

Genesee and Wayne Counties do have 2008 median incomes below the state's. Flint, Mich., in in Genesee County and Detroit is in Wayne, and, combined, the two counties have reported 185 cases of pertussis.

Michigan has put some data online for 2009 concerning pertussis cases in that year. The second highest number of cases of vaccine-preventable disease was from pertussis with 902. A county map reveals a clustering pattern similar to that of 2010, with Oakland, Wayne and Washtenaw Counties alone representing one-third of all the cases in the state. Two-thirds of all whooping cough cases in Michigan in 2009 were in children under age 19, and 26 percent of those patients did not have documentation of the pertussis immunizations recommended for their age group.

Michigan is one of 20 states that permit parents to refuse to immunize their children based on some sort of strong personal belief. The Michigan law reads:

"A child is exempt from this part if a parent, guardian, or person in loco parentis of the child presents a written statement to the administrator of the child's school or operator of the group program to the effect that the requirements of this part cannot be met because of religious convictions or other objection to immunization."