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    What California Is Doing

    The state of California has issued alerts to doctors, urging them to be vigilant for possible cases. In Los Angeles County, officials are pushing widespread vaccinations, says Jonathan Fielding, MD, director of public health for the county and county health officer. Like others, he advocates the cocooning concept. '''I think we have to be much more careful about who is around small babies," he tells WebMD.

    "Hospitals and doctors should be keeping track of immunizations and making sure anyone who is going to be around small children is up to date on immunizations," he says.

    Hospitals are doing just that. At Cedars-Sinai Medical Center in Los Angeles, for instance, women who have given birth there and have not had the vaccine are urged to get it before going home, says Debbie Lehman, MD, associate director of pediatric infectious diseases at Cedars-Sinai's Maxine Dunitz Children's Health Center.

    The medical center also is urging all health care workers to be up to date on pertussis vaccine. If they refuse, they must sign a ''declination" form, she tells WebMD.

    Lehman is hopeful that will persuade them to change their mind and get vaccinated. The declination form seems to work that way, she says, for the influenza vaccine. She is also reaching out to fathers and grandparents of newborns, urging them to visit their own doctors and get immunized.

    What Parents Can Do

    If parents are concerned that their child has pertussis -- and the symptoms seem to support that concern, Cherry urges them to ask the doctor for testing. Of some doctors, he says, "They have to be prodded. The illness doesn't look bad."

    Parents can also ask for a white blood cell count, as high counts are common in severely ill babies, says Cherry, who has worked as a consultant for the new adult vaccines and served on a speaker's bureau for vaccine makers.

    One Mother's Campaign

    While public health and safety fuel the efforts of the CDC and the states, Bianchi seems driven by grief turned to activism.

    In an instant, she can take you back to that day in the hospital, when she and her husband, David, frantically followed the ambulance that transferred their son to another facility to better care for him, then heard the tragic news that their baby had gone into cardiac arrest. CPR had proven fruitless, and the parents were offered a last visit.

    "He had the sweetest face," Mariah says. "A little heart-shaped chin, and auburn hair."

    Just as quickly, she comes back to the moment and her decision to channel ''all that anger and all that energy'' to making sure other children won't be lost to a preventable disease. "I know what it's like to have this happen."