EDGEWOOD, Ky. – For several years, Northern Kentucky has been battling outbreaks of pertussis, commonly known as whooping cough. Hundreds of cases have been reported as the virus continues to grip the region.
And on the front lines of that ongoing battle is Christina Rust.
Rust is a longtime health care professional who serves as the maternal child health education specialist with St. Elizabeth Healthcare. Through the “cocooning project” she spearheaded, more than 25,000 free pertussis vaccines have been administered to mothers and family members over the past five years at St. E.
All that work has not gone unnoticed: Toward the end of April, Rust was named the Centers for Disease Control and Prevention's Childhood Immunization Champion for her efforts to increase whooping cough vaccination rates among mothers and families delivering at St. E.
Boosting vaccination rates is a key part of the equation to ensure that the outbreaks don't spread, and Rust played a big role in bringing the cocooning project – which aims to “cocoon” the newborn by immunizing everyone in close proximity for the child's protection – to St. E.
“A lot of her role was just trying to get it instituted in the hospital itself, and to do that, there are a lot of things that have to take place,” said Sonya Moseley, immunization program coordinator with the Northern Kentucky Health Department and immunization field representative with the Kentucky Immunization Program. “She was very involved with meeting with all the different people in that hospital. It was a lot of work on her end and she does a great job. She's really passionate about this.”
Passion For Care
Rust, 58, has always been passionate about heath care. After graduating from Our Lady of Angels, which is now Roger Bacon High School, she went to the University of Cincinnati's College of Nursing to get her undergraduate degree and later obtained both her master's degree and doctorate in nursing from Northern Kentucky University.
For 25 years, she worked in obstetrics at Good Samaritan Hospital in Cincinnati, and for the past 13 years she's spent most of her time in OB at St. Elizabeth.
“Currently, my role is education specialist, so I'm responsible for the education of staff nurses and all other staff in maternal health,” Rust said. “I help out with deliveries and things like that on the floor when it's busy. I get to do all kinds of really cool things here.”
Aside from her role as education specialist, which she's held since 2005, the Florence resident is also an adjunct faculty member at NKU in the RN to BSN program.
Her passion for care is what incited Rust to action in 2010, when a particularly bad outbreak of pertussis took hold. The rate in Northern Kentucky was higher than any other place in the state, Rust said.
That year, 127 cases shook the region, affecting mainly preschoolers ages 1-5, said Moseley, who also works with Rust on an immunization coalition called Let's Immunize Northern Kentucky (LINK).
“I was really concerned because babies can die from this, and it is a preventable disease,” Rust said. “It's preventable through the vaccine. I had talked to St. Elizabeth about trying to get an immunization program going, so we were trying to work on that.”
Amid those discussions, the Kentucky Department for Public Health got in touch with hospital administrators to inform them that the agency, with money from a tobacco settlement, wanted to help St. E to provide free pertussis vaccines to all mothers, family members and babies that were born at the hospital. With funding made available, the “cocooning project” took off.
Rust worked with St. E. as well as local and state immunization program staff – including Moseley – to create the program and implement it. She also worked to ensure that local obstetricians follow the latest recommendations for whooping cough immunization during pregnancy.
“It's really been an effort by everyone to keep (pertussis) to where we're not seeing it spread too much,” Moseley said.
The main focus for the cocooning program is to protect the infants since they are at a higher risk for serious complications, hospitalization and even death, Moseley said. The cocooning clinic for pertussis takes place at the hospital every day for a one-hour period and is staffed by nurses in the postpartum unit. All family members – anyone over 18 who will come into contact with the infant – are sent to the clinic every morning, and staff typically administer anywhere from 20-40 vaccines in an hour.
“We give moms the vaccine on the postpartum unit, in their prenatal visit, in triage or ultrasound – wherever we encounter them during their pregnancy,” Rust said.
The public health department had given the hospital enough funding for four years; last year, the funds ran out. Attempts to secure grants to continue the program were unsuccessful, but hospital administrators decided they wanted to pay for the program because they knew it was valuable, Rust said.
In June 2015, St. Elizabeth Healthcare started paying for all the vaccines, which cost upward of $150,000 per year. This January, when there was another surge of pertussis in Northern Kentucky, the state intervened and offered to fund the cocooning project again on a one-year basis, starting in February.
“We'll see what happens after that,” Rust said.
So far, since the program was implemented in 2011, it's been highly successful. Approximately 5,000 vaccines are given per year, and now that it's approaching the end of year five, more than 25,000 vaccines have been administered.
“That is pretty amazing,” Rust said. “And we're the only hospital in the state of Kentucky that is giving the vaccine for free to all those people.”
That aspect of the project is particularly rewarding, she said.
“A lot of our population can't afford the vaccine, or their insurance doesn't cover it,” Rust said. “To be able to provide this service for free for anybody who is delivering in our organization is just amazing. If we can prevent one baby from dying from whooping cough, that is just a tremendous reward on our part.”
Nowadays, in an era when the idea of vaccination is such a hotly contested issue, Rust noted that she and other health care professionals and educators do struggle with pushback from anti-vaccine sentiments as they continue to work on boosting immunization rates.
All they can really do, Rust said, is provide those people with the facts they need.
“Literature shows that (infants) most often get whooping cough from their mother or family members, and after that it would be a sibling, so that's why we do the cocooning project – so we can immunize everyone around the baby until they can get full immunization status at 6 months of age,” she said. “Making sure the parents have all the correct information to make an informed decision is the most important thing.”
'A Great Place To Be'
The goal of the cocooning project is to have 90 percent of the community vaccinated. While Rust is unsure what the percentage is now for the Northern Kentucky population as a whole, St. E is averaging somewhere between 86 and 88 percent of moms being vaccinated before or after the birth of their baby.
Though pertussis is a fickle disease – health care professionals will work to make a dent only to have the virus surface again – the program appears to have made an impact so far.
“It does seem like at least the adult number of pertussis cases is going down,” Rust said. “We haven't had any babies die from pertussis in a couple years – hopefully that means this is working.”
What Is Pertussis?
According to the Centers for Disease Control and Prevention, pertussis is a highly contagious respiratory disease. It's known for uncontrollable, violent coughing that often makes it hard to breathe. After fits of coughs, someone with pertussis often needs to take deep breaths, which results in a “whooping” sound. Pertussis can affect people of all ages, but it can be especially serious – and even deadly – for babies younger than a year.
For more information, visit cdc.gov/pertussis/.