Southern Arizona may be on the verge of a whooping cough outbreak, according to doctors at the University of Arizona Medical Center.
Whooping cough, or pertussis, is a highly contagious respiratory infection that causes severe coughing fits that leave sufferers gasping, or “whooping,” for air. A higher than average number of cases in Pima County this year has raised concern about an impending outbreak.
“Pertussis outbreaks occur about every three to five years, and we’re due for one,” said Dr. Sean Elliott, medical director of infection prevention for the UA Health Network.
Hospitals in Pima County usually see about 40 to 50 cases of the disease annually, Elliott said, adding that during an outbreak, the number could surge to 10 to 100 times that amount.
Currently, Texas is experiencing a pertussis outbreak, as California did last year, he said.
“It may be that we’re on the brink of an outbreak … or that we’ll see it in the next year or so,” Elliott said, adding that early fall and winter are usually the months with the highest incidence of pertussis.
Symptoms of pertussis include about a week of flu-like symptoms that give way to a prolonged period characterized by persistent coughing that can be extremely painful, he added.
“[People] have broken ribs with the cough,” Elliott said. “It’s that bad.”
The disease is particularly dangerous for newborn infants. Elliott said the eight or nine pediatric cases reported in the county during the last two months are slightly above average.
Newborn infants are more susceptible to whooping cough than the rest of the population because their developing immune systems can be caught unprepared by the infection, said Dr. Chan Lowe, associate professor in pediatrics and section chief of Hospital Medicine and Outreach at Diamond Children’s.
Although newborns usually receive immunizations when they are two months old, along with periodic “boosters” over the course of their first year, they are highly susceptible to the infection during their first six months because the vaccination hasn’t reached its full strength, Lowe said.
For teenagers and college students, who likely received their last injection at the age of four, Lowe recommended getting the Tdap booster, as the effects of the original injection will have diminished considerably.
“The best way to protect the babies is actually to get everybody else immunized,” he said.
If an outbreak were to occur, Lowe said the doctors in his department would likely begin to give infants their DTaP shots earlier, beginning at six weeks. However, the effectiveness of that strategy would be limited.
Infants sometimes need to be intubated, meaning that a breathing tube is inserted into the infant’s trachea to supply oxygen to their overstressed lungs. However, this can cause further complications.
“It’s terrible,” he said. “It’s such a tricky disease because the throat is irritated, so when we put the breathing tube in, that makes them cough even worse, and then we end up having to paralyze the babies to keep them sedated.”
To avoid catching the “100 day cough,” Elliott said students should cover their mouths while coughing or sneezing and wash their hands frequently.
Although he said he knows it may be difficult for college students who are “hitting the books,” he said that “one of the best ways to stay healthy, both from infections and in general, is to get lots of sleep.”
David Salafsky, director of health promotion and preventive services for the UA’s Campus Health Service, said that although he has not seen an uptick in pertussis cases among students, the Tdap booster is something “everyone should get.”
“Know your vaccination status,” Salafsky said. “If everybody is immunized, then [pertussis] is less likely to spread.”
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