800 Percent Spike In PA Whooping Cough Cases Since Last Year: CDC Data

PENNSYLVANIA — Along with a summer spike in COVID-19, health officials are alerting residents about a rise in whooping cough infections around Pennsylvania as students head back to school.

The highly-contagious respiratory illness is spread from person to person, typically through the air. Cases of whooping cough (pertussis) were lower than usual over the past several years but have begun to climb to pre-pandemic levels, according to the Centers for Disease Control and Prevention.

Nationally, the number of cases has more than tripled since this time last year, CDC data shows. As of Aug. 17, there have been 1,666 cases reported in Pennsylvania — an increase of about 830 percent since last August, when there were 179 cases.

"It’s likely that preventative actions used during the pandemic (e.g., good hygiene, distancing) lowered transmission of this disease," the CDC said in its latest report. "We’re now beginning to return to pre-pandemic levels, where we typically see more than 10,000 cases of people with whooping cough each year. The number of reported cases this year is close to what was seen at the same time in 2019."

Dr. Ericka Hayes, professor of clinical pediatrics at the Children’s Hospital of Philadelphia, said local doctors have seen a “marked increase” in whooping cough cases since March. She said two infants have been hospitalized at CHOP with serious cases of whooping cough this summer.

Hayes said cases have been rising in Chester, Delaware, Bucks, and Montgomery counties, as well as Burlington County in South Jersey.

Whooping cough is caused by a bacteria that attaches to the tiny, hair-like cilia that line the upper respiratory system. These bacteria release toxins which damage the cilia, and cause airways to swell.

And, babies and children under 10 years old may present with different symptoms than adults and older children.

Infants under 6 months old, and those who were born prematurely, are more susceptible to the disease – and 50 percent of babies who get whooping cough will have to be hospitalized, Hayes said. Health experts encourage pregnant women to be sure they are properly vaccinated against whooping cough, to lessen any symptoms they or the baby might experience if they get sick.

Newborns and young infants do not have the lung strength to develop the “whoop” sound but will still have trouble breathing, Hayes said.

“They can present with poor feeding, lethargy, stopping breathing or turning blue,” Hayes said.

In children under 10, excessive coughing can also cause the child to vomit.

Hayes added that part of the increase in cases is due to a decline in vaccination rates, and the fact that most people are not as vigilant with hand-washing and wearing face masks as during the height of the COVID-19 pandemic.

“We haven’t gotten back on top of vaccines, but we see surges in pertussis even when rates are good,” Hayes told Patch.

Hayes said that adults need boosters for the TDaP vaccine, which protects against tetanus, diphtheria, and pertussis, to protect themselves and others in their household.

The current TDaP vaccine is acellular and contains an inactivated pertussis toxin, which Hayes said does not provide as much “durable immunity” as past vaccines– before 1991, the pertussis vaccine used whole cells, but also had more side effects, she said.

According to the CDC, a typical case of pertussis starts with a cough and runny nose for one to two weeks, followed by weeks to months of rapid coughing fits. These coughing spells sometimes end with a whooping sound as the person gasps for air, hence the name "whooping cough." Fever, if present, is usually mild.

Symptoms can vary for people based on their age and if they've been vaccinated or not, and health experts say that antibiotics can lessen the severity of symptoms and prevent the spread of disease to others.

Health officials strongly urge pregnant women and people who come into close contact with young infants to get vaccinated. Newborns are at the greatest risk of getting whooping cough, since they are too young to be fully vaccinated.

The CDC recommends the following schedule for the TDaP (diphtheria, tetanus, and acellular pertussis) vaccination that helps protect people from whooping cough:

• A TDaP booster is recommended for pregnant women early in their third trimester and during each pregnancy to protect their newborns.
• Young children need five TDaP doses by kindergarten: at 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years.
• After that, the first TDaP booster is due at age 11. All students entering seventh grade are required to have proof of a whooping cough booster immunization.
• One dose of TDaP is recommended for adults 19 years of age and older who did not get Tdap as a teenager.
• After that, getting TDaP instead of the standard tetanus shot every 10 years will also reduce infections.