Pertussis, also known as whooping cough, has been spreading rapidly throughout the country. Preliminary from the Centers for Disease Control show that more than six times as many cases were reported in 2024 compared to the same time in 2023, reaching a level higher than in 2019, period to the pandemic.
That’s not surprising: Pertussis tends to be cyclical, with spikes in cases every three to five years. During the pandemic years, prevention measures such as social distancing, hand washing and masking helped to prevent transmission of many respiratory illnesses, including pertussis. Montana reported only one case of pertussis in 2021 and three cases in 2022.
Pertussis is a highly contagious respiratory illness spread through respiratory droplets expelled when infected people cough, sneeze or talk. The infection is caused by a type of bacteria called Bordetella pertussis.
Infection starts much like a common cold. Early symptoms of congestion, runny nose, mild cough, and a low-grade fever can last for one to two weeks. The cough generally gets worse and becomes more common as the illness continues.
The next stage is often when classic signs of whooping cough present. People may develop paroxysms, known as coughing fits, that continue for weeks. (Pertussis is often referred to as the “100-day cough.”) Paroxysms can cause a high-pitched “whoop” during inspiration. These coughing fits can induce vomiting, loss of breath and fatigue.
Although “whooping” may not occur in very young children, pertussis is most threatening in infants, those younger than 12 months. Infants may have symptoms known as “apnea,” a pause in the child’s breathing pattern. About one-third of infants who contract the disease must be hospitalized for treatment. This age group is at greatest risk for serious illness, complications, and even death because their bodies and immune systems are still developing. Sadly, babies continue to have the highest reported rate of pertussis.
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The illness is often milder and the hallmark “whoop” absent in older children, teens, and adults who have been vaccinated. However, those with underlying medical conditions are also at risk for a more severe infection or complications such as pneumonia or hospitalization.
Often the illness is spread unknowingly by people with mild symptoms who are not aware they have whooping cough. If you experience a persistent cough lasting more than a week or fits of coughing, it is recommended you wear a mask and visit your healthcare provider for assessment.
The good news is this serious bacterial infection can be prevented or lessened with vaccines and treated with antibiotics. It is recommended that people suspected of having pertussis complete five days of appropriate antibiotic treatment or be sure 21 days have passed since the onset of cough before returning to daycare, school, work or public events.
Healthy people who have been exposed to pertussis should be alert for symptoms for three weeks after exposure. If any symptoms develop, see a healthcare provider for testing and treatment. People with higher risk for infection or complications such as household members, pregnant people, the very young or old, those with chronic respiratory or immunocompromised conditions, should talk with their healthcare provider about treatment if they are exposed to pertussis.
Vaccination is the best way to prevent pertussis. Before the availability of a pertussis vaccine in the 1940s, public health experts reported between 100,000 and 200,000+ cases of pertussis annually. That number dropped significantly after licensure of the vaccine, and in 1976, the U.S. reported just 1,010 cases.
Vaccines work well; however, no vaccine provides 100% immunity, and no community is 100% vaccinated. We also know pertussis vaccines wane over time as does immunity from the disease. The Advisory Committee on Immunization Practice recommendations include a series of vaccines against pertussis. Getting all doses of the vaccine can help protect us as a community from serious outcomes of the disease.
The Jefferson County Health Department and many healthcare providers offer pertussis vaccinations for all eligible people, including:
• Adults who have not received a Tdap booster
• Pregnant women during the third trimester of each pregnancy
• Children and adolescents who need routine vaccinations
Remember, whooping cough spreads very easily. Infection can be serious, especially for babies. Pertussis preventing vaccines work well; however, protection decreases over time, so it is important to stay up to date. Early treatment with an appropriate antibiotic if diagnosed with pertussis is important to ease symptoms and prevent spreading illness to others. And non-pharmaceutical intervention such as good hand washing, covering coughs, and staying home when ill work to stop the spread of illness.
Stay well!
Pam Hanna is Jefferson County’s public health supervisor.
