An ongoing Spokane County Health District study indicates whooping cough may be almost commonplace among Spokane teenagers.
More than 10 percent of the teens recently tested at Gonzaga Prep and Cataldo Catholic School suffered from the incessant cough that can kill infants.
County epidemiologist Paul Stepak is leading the investigation, which has verified 27 cases of the illness in the past two weeks.
Stepak suspects he could find similar whooping cough, or pertussis, levels among other Spokane teenagers, but he isn’t sure how long the county can afford to examine the disease.
The health study was sparked by a Gonzaga Prep cross-country runner’s visit to Spokane pediatrician Kennard Kapstafer.
“He couldn’t do anything because he was so short of breath,” Kapstafer said of his 17-year-old patient. “It was obvious he was trying to suppress a cough that was kind of overwhelming him.”
On a hunch, Kapstafer ran a test for whooping cough. Bingo. The next day, the runner’s younger brother, who attends Cataldo, was tested. He also came up positive.
Stepak responded to the news by testing a growing theory that whooping cough is more widespread among adolescents than doctors and the public realize.
While the disease can make infants cough so hard they can’t breathe, it often goes undiagnosed in teenagers who mistake it for a relentless month-long cough. It can be treated with antibiotics.
Stepak launched the health study by getting a list of 132 Gonzaga Prep students who were in some contact with the sick runner. He also got the list of another 60 kids who go to school with his brother.
Stepak and his staff called the families and asked if the students had experienced a cough, sore throat, fever or congestion during the past month.
More than 100 students and several others were then tested for whooping cough. Of them, 27 turned up positive.
“This has led me to believe that there is more pertussis here than gets reported,” Stepak said.
By contrast, there were only four confirmed cases of whooping cough in Spokane County last year. A similar, smaller study of elementary school students in 1994 found only a couple cases.
Stepak said childhood vaccinations are wearing off by adolescence, leaving teenagers vulnerable to milder bouts of the disease.
“What we really did is open a window on an ongoing process, an endemic disease,” Stepak said.
Stepak said serious problems emerge if infants are exposed to the infected teenagers.
“We’re not waiting for it to arrive to town,” he said. “If we fall down on the job of immunization it’s not a question of the possibility of pertussis finding its way to little kids, it’s going to happen.”
Most children get four shots for whooping cough before they are 4 years old. The “DPT” shot diphtheria, pertussis and tetanus - is usually the first shot an infant receives.
The immunity is strongest through elementary school, then wanes through middle school and high school.
Two years ago, Kapstafer watched a 4-month-old patient struggle with whooping cough. The baby was in intensive care for a month.
“It would cough and cough and cough until it turned gray,” he said. The baby survived.