September 21, 2016 – The Nevada County Public Health Department is receiving increased reports of pertussis (commonly called “whooping cough”) particularly in western Nevada County. As of September 19, 2016, there have been 31 cases reported in this calendar year, including 10 in the past month. Patients have ranged from infants to seniors with most being in the 10-19 year old range. No deaths have been reported. However, two infants were hospitalized earlier in the year when case numbers overall were low. The health department continues to work with local healthcare providers to identify additional cases.
Infants are at the greatest risk of contracting pertussis and having severe complications from it, so protecting infants is critical. Many babies who get ill with pertussis get it from a household contact, and approximately half of babies less than 1 year old who get pertussis need treatment in the hospital. Therefore, those who are pregnant or live with or care for babies are a high priority for vaccination and pertussis vaccination is recommended with each pregnancy early in the third trimester so the mother passes protective antibodies to the baby before birth.
Pertussis outbreaks occur every 3-5 years and the last large California outbreak was in 2014 when more than 11,000 cases were reported in the state. Of note, the last peak of pertussis in Nevada County was in 2013 when more than 70 cases were reported and this preceded the statewide outbreak. The outbreaks can be difficult to control because pertussis spreads easily through coughing and sneezing, much of it goes undiagnosed, and the protection from pertussis vaccines decreases within a few years.
Pertussis starts off looking like a common-cold before the characteristic whoop or coughing fits appear. Patients with pertussis are considered contagious from the onset of symptoms until 3 weeks of cough or 5 days of effective antibiotics. After exposure, pertussis can incubate in the body for up to 3 weeks before symptoms start. The vaccine is effective but not 100%, and immunity wanes. Plus, many people with pertussis never seek medical care. All these factors mean that pertussis outbreaks can last for months.
According to the Nevada County Health Officer, Dr. Ken Cutler, “While it is important for everyone to be up to date on their immunizations, the main goal of the disease control effort is to decrease pertussis disease and death among babies. Community members are encouraged to talk with their healthcare provider about the prevention and treatment of pertussis.”