ANSON, Maine — Four cases of whooping cough have been confirmed in Maine. Five children at a central Maine elementary school are out of school because of the disease, and residents in Anson are taking action.

The school district sent letters to parents last week notifying them about the initial cases. The district held a meeting on Wednesday to inform parents and try to stop the spread of the disease.

“I’m sure there are parents that are concerned.” Teresa Griffith, a parent, said.

Anson is on high alert now that five students are out of school for whooping cough.

“The first step is exclusion and to stop contact, and then once students are on the antibiotics for five days, they’re able to come back to school and participate because they’re no longer infectious even though they still have some of the symptoms,” said RSU 74 Superintendent Ken Coville.

Coville said they’ve seen whooping cough before but on a smaller scale.

According to the U.S. Centers for Disease Control and Prevention, it’s a respiratory illness spread through the air by coughing or sneezing. It can cause vomiting and difficulty breathing.

“Whooping cough is a very serious condition,” Coville said.

Coville said it’s especially difficult to prevent the spread in Maine. It’s one of four states that do not require the booster shot for students at age 12.

“So many children throughout the state do not have that booster vaccination because it’s not required for school attendance, and that’s a concern because that protection that they have from the vaccination does fade over time and starts to go away when they’re about 10, 11, 12 years old,” Coville said.

Some parents such as Griffith aren’t worried about it.

“I feel there’s no concern for me because I’ve taught my child and my children not how to cough, how to keep themselves clean,” Griffith said.

But Coville said many parents are concerned, and education is critical.

“Because the more information we have to the more parents and the more active parents are in monitoring and addressing any concerns that arise, the less likely there is a further spread,” Coville said.

The superintendent said the last time a student in the district had whooping cough was in January, and it was not spread to any other students.

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