Betsy Bertelsen and Dr. Francisco R. Velázquez: Could it be whooping cough?

Over the past few months, the Spokane Regional Health District has seen an increase in the number of probable and confirmed cases of whooping cough in the Pacific Northwest.

Pertussis is known to be a cyclical infection, with cases increasing every three to five years. The most recent outbreak in Spokane County was in the fall of 2019. As of Aug. 10, there have been 578 cases of pertussis reported across multiple counties in Washington, including Spokane County, compared to just 37 cases in the same period in 2023. Cases locally are increasing each week.

Pertussis, also known as whooping cough, is a respiratory illness caused by the bacteria Bordetella pertussis. The disease has been known for centuries, and perhaps millennia. The first epidemic in modern history is documented in Paris in 1578. It is believed that the disease spread to the Americas with the many exploration voyages during the 15th and 16th centuries.

The symptoms and severity of pertussis can vary for people based on a variety of factors, including age, health conditions and vaccination status. Pertussis can be severe for some people, including infants younger than 1 year of age, and those who are at the greatest risk for severe disease and death. Pregnant women and persons with underlying health conditions can also be at higher risk of complications from a pertussis infection.

It spreads easily from person to person through droplet transmission, such as coughing or sneezing. A person with pertussis is contagious for several weeks, or until they have completed the appropriate antibiotics for the infection. Early diagnosis is important as timely treatment decreases severity and helps prevent further spread. Even after appropriate antibiotic treatment, people with pertussis may cough for several more days to weeks, but they are no longer contagious to others.

Recognizing the symptoms of pertussis can be difficult, especially in the early stages of infection. Some cases may present with nonspecific respiratory symptoms and may not initially include a cough. As the infection progresses, the cough will usually worsen and often include paroxysms, or fits, of coughing. In some cases, the cough may follow with vomiting or have a “whoop” at the end of the cough. Other cases may have less severe symptoms and appear mild.

The best protection from pertussis is with vaccination. It is important for providers to educate their patients on the safety and efficacy and to ensure they are up to date on their vaccinations per national guidelines. The pertussis vaccine is included in the DTap and Tdap vaccines (diphtheria, tetanus and pertussis). It is also important to keep in mind a Tdap vaccine is recommended during each pregnancy (ideally during weeks 27 through 36) to help protect the mother and infant.

If your child has a persistent cough, contact your provider to arrange for the appropriate testing and treatment, if necessary. As we prepare to go back to school, it’s important that all students are appropriately immunized and that we all work together to prevent the spread of whooping cough. For more information about pertussis, recommended childhood vaccinations and vaccination clinics, visit srhd.org.

Betsy Bertelsen, RN, BSN, is an epidemiologist and Francisco R. Velázquez, M.D., S.M., FCAP, is the health officer at the Spokane Regional Health District.