San Rafael, CA – Pertussis, commonly known as whooping cough, is on the rise in Marin and other parts of California. In the first three months of 2018, 78 cases have been reported in Marin, compared to 30 cases in 2016 and 44 in 2017. Most people treated this year have been high-school and middle-school students.
The disease is cyclical, with cases peaking every three to five years. In California, over 9000 cases of pertussis were reported in 2010, 347 in Marin. In 2014, 10,831 cases were reported state-wide, including two infant deaths and hundreds of hospitalizations, with 264 Marin cases.
Whooping cough is a highly contagious bacterial disease. Within three to five days of antibiotic treatment, the disease is no longer transmissible to others. While most adolescents and adults recover without complications, the disease can be fatal for babies under one year of age.
Signs and symptoms initially include fatigue, runny nose, sneezing and mild cough. As the disease progresses one to two weeks later, symptoms include severe coughing episodes which can go on for up to 10 weeks or more (child can make a whooping sound as he/she tries to take a breath). Vomiting after a coughing episode is also common in all ages. Fever can be absent or persistent and low grade.
“Infants under one year are at the greatest risk for whooping cough and having serious complications” said Dr. Lisa Santora, Deputy Public Health Officer. “The best way to protect an infant is for all pregnant women to get at Tdap booster in the third trimester which helps pass on protection to the baby until she or he can get a first vaccine at six to eight weeks of age. Anyone who is around a pregnant woman or child under one year should get a Tdap booster which will essentially cocoon that infant from the risk of disease.”
Whooping cough vaccines are effective, but short term. They offer good levels of protection within the first two years after getting the vaccine, but the protection decreases over time- it’s called “waning immunity”. For this reason, the disease is more common in middle and high-school age populations as immunity can decrease. Vaccination is most effective at protecting babies who are at the highest risk of having severe illness.
Health experts think that the whooping cough epidemic could be driven by
a combination of the waning effectiveness of the vaccine and an increase
in the bacteria circulating in the community, not necessarily a lack of
vaccination. Also, getting the disease once does not mean a person
develops immunity, they can get it again in the future.
Many whooping cough cases were in teenagers who were completely
vaccinated as children and prior to entry to seventh grade as
recommended. Vaccination is still important; children who are not
vaccinated have eight times the risk of the contracting the disease. Also,
the disease tends to be less severe for those who have been vaccinated.
Marin County recommends:
The most effective way to prevent the spread of whooping cough is
vaccination. Infants and children should complete the DTaP series as
scheduled and pre-teens adolescents and adults should have a current
Tdap booster.
Pregnant women should get the whooping cough vaccine at 27-36 weeks
gestation. Anyone who is in contact with an infant or pregnant woman
should also get a Tdap booster. If you suspect you have the disease,
seek medical care and treatment. Your provider can test if you have
contracted it.
Cover your cough, sneeze in a tissue and dispose in a waste basket. You
should also wash your hands and stay home from school or work until
three days of antibiotic treatment have been completed. Your provider
may also recommend that others in the household get antibiotics for
disease prevention.
For more information, call Marin Communicable Disease Prevention and
Control at 415-473-4163.
For more information about pertussis visit the Centers for Disease Control
and Prevention and the California Department of Public Health.