Whooping cough cases are rising to new high levels in Pa.

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Whooping cough is making a big comeback in communities nationwide, with especially high numbers in Pennsylvania.

The commonwealth has recorded about 2,008 cases of this bacterial infection, also known as pertussis, so far this year — that’s 10 times the number seen at this point last year and the highest in any single state or territory nationally, according to federal data.

Public health experts and researchers say the rise in cases and infections is likely part of the disease’s return to circulation after years of low activity during the pandemic.

“It went away because it spreads through respiratory droplets, and all the COVID measures really helped us decrease its incidence,” said Dana Perella, acute communicable disease program manager at the Philadelphia Department of Public Health. “But it’s increasing again and we’re seeing kind of higher than what we had in pre-pandemic years.”

But it’s unclear why this hasn’t happened sooner and why some areas are seeing exceptionally high cases over others.

Health officials say they’re closely monitoring whooping cough outbreaks in communities, especially in schools, daycares and hospital admissions.

Whooping cough, at first, can look like other common respiratory illnesses. Symptoms include a runny or stuffy nose, fever and a mild cough. But about a week or two later, someone with an infection could develop difficulty breathing and painful coughing fits, “characterized by this high-pitched whoop sound when someone is inhaling after they cough,” explained Perella.

“The coughing fits are so violent, they make someone feel very tired and very fatigued after the fit. It may cause difficulty breathing at night and fractured ribs.”

In severe cases, people can become hospitalized and develop sleep apnea, pneumonia and brain swelling. One in 100 people will die from complications, according to the Centers for Disease Control and Prevention.

Antibiotics for bacterial infections and illnesses

Whooping cough can be successfully treated with antibiotics. Perella said people who suspect they’ve been infected should seek testing and medication as soon as possible.

“The treatment helps with stopping the bacteria from being contagious,” she said. “Say we have a school student who is diagnosed with pertussis — we let them go back to school after five days of antibiotics, whereas they’re contagious for three weeks if they’re untreated.”

A post-exposure prophylactic course of antibiotics may also be prescribed for other household members and close contacts.

Infants and young children are most at risk of severe illness. Seniors and other adults who have immunocompromised conditions or chronic diseases like asthma can also develop complications.

In a statewide health advisory issued earlier this month, Pennsylvania Department of Health officials said there has been an increase in hospitalizations of older adults with whooping cough this year.

“This is likely due to a multitude of factors, including waning vaccine protection and the lack of timely recognition and testing by adult providers, leading to more severe infections, co-infections and hospitalizations,” the advisory stated.

The state health department warned that all health care providers should have an “increased suspicion of pertussis in all patients who present with symptoms.”

DTap and Tdap vaccines for kids and adults

To prevent or reduce the likelihood of illness from the start, Perella said children and adults should be up to date on their pertussis vaccinations, which are given as part of the standard childhood immunization schedule and as boosters later in life.

A total of five doses of the DTaP vaccine, which also includes protection against diphtheria and tetanus, are given to children at two months, four months, six months, between 15 to 18 months, and between four and six years.

One dose of Tdap, a similar combination vaccine against the same set of diseases, is recommended for kids 11 to 12 years old and for pregnant people between 27 and 36 weeks of gestation.

“There is a passing along of antibodies to the newborn during that time frame,” Perella said. “So, it’s a way to help protect those most at risk for severe disease.”

Pertussis vaccine boosters are also recommended for any adults or caregivers who will be in close contact with newborns.

“If you are an older adult and you have grandkids in particular who are too young to have gotten their primary vaccine series yet, you must make sure that your pertussis vaccine is up to date,” said Dr. Richard Lorraine, medical director at the Montgomery County Health Department. “As much as you don’t want to get pertussis, which is a nasty illness, you certainly don’t want to give it to a baby.”

In all other cases, the CDC recommends a routine Tdap vaccine for all adults every 10 years.

While vaccines don’t 100% completely prevent infection, they effectively reduce severe illness in the immediate years following immunization.

Before the pandemic, Pennsylvania had recorded 649 cases of whooping cough in 2017, 311 cases in 2018, and 278 cases in 2019 by mid-September. Perella said it may take time for the disease to return to typical levels.

“It may take this academic year, and then it will start mellowing out again or going back to that baseline,” she said.