State reports spike in whooping cough cases, recommends vaccination

Nov. 5—The Alabama Department of Public Health is reporting a tripling in the number of whooping cough cases over last year and is advising people to get immunized.

ADPH said the number of pertussis, or whooping cough, cases has increased from 41 cases in 2023 to 124 cases in 2024. The cases this year occurred in schools in the following public health districts: four outbreaks in the northern district, in Limestone, Madison, Lauderdale and Jackson counties; two outbreaks in the southwestern district in Baldwin and Dallas counties; and one outbreak in Jefferson County. ADPH would not release the names of the schools involved.

"Obviously there are many reasons we are seeing pertussis come back, one of them being that people might not be up to date on their vaccines," said Dr. Karen Landers, chief medical officer of ADPH. "The other is the vaccine is not 100%. Finally, we've come out of a pretty severe respiratory situation with COVID over the last few years and these other respiratory bacteria and viruses are showing that they are still around," she said.

Pertussis is a bacterium that causes a respiratory illness and is spread by close contact with an infected individual. Landers recommended hand washing, covering coughs and staying at home when ill as good preventive measures.

The disease begins with common cold symptoms and can progress to a severe but intermittent cough that can last up to three months. Most individuals do not suffer life-threatening complications from pertussis infections, but some may, including those with compromised immune systems and young infants, according to ADPH. Not every person exposed to the pertussis bacteria will develop the disease.

"It's very hard to diagnose because the symptoms are similar to the common cold in the beginning," said Dr. Wes Stubblefield of ADPH. "Then it turns into the long-term cough only after a few weeks."

The best way to prevent pertussis is vaccination, he said,

"Vaccination is not 100% but it's the only thing we have for prevention," Stubblefield said.

He said in outbreak situations people who are exposed in a home setting can take antibiotics to prevent it but that's only when you know someone has had it.

A vaccine for pertussis is given during childhood as a component of the DTaP vaccine. Five doses of vaccine are required for entry into school in Alabama unless an exemption is made, according to ADPH. The vaccine does provide some protection against the disease; however, this protection wanes over time and a booster dose (TdaP) is required by state law before entry into the sixth grade.

Pertussis immunization does not provide complete protection in the population and will not prevent the disease from developing in already exposed individuals, ADPH said.

The disease is usually only spread during the first 21 days of infection in healthy individuals. The treatment is a five-day antibiotic course that is well tolerated, according to ADPH.

Close contacts at schools, where most outbreaks occur, are defined as persons with exposure to a pertussis case where contact with "respiratory aerosols" is likely, ADPH said. The following are considered significant exposures:

—Being a household member.

—Attending or working in the same child care setting.

—Receiving a cough or sneeze in the face.

—Performing a medical examination of the mouth, nose or throat.

—Sitting at adjacent desks or the same table at school.

—Sharing a confined space with an infectious person for more than one hour.