In the first half of 2024, 101 cases of pertussis, also known as ” whooping cough,” were reported in King County—more than three times the number of cases reported in all of 2023.
That’s got Public Health — Seattle & King County officials ringing the vaccination alarm.
Although whooping cough spikes or “epidemic cycles” commonly occur every three to five years, says public health program manager Debra Berliner, the county’s 2024 count so far is “way higher than what we have seen in recent years. People across the county are getting sick with whooping cough, but South King County has been hardest hit.”
Find no-cost vaccinations
All vaccinations are available free to charge to any person 18 years and younger in Washington state and free vaccinations are available for adults as well. To find out where you can get the Tdap and other vaccines at low or no cost, whether you are insured or uninsured, visit kingcounty.gov/findaclinic.
“Most of these cases—78%—are among children,” says Berliner. “We’ve had five hospitalizations, and three of these have been infants. We get most concerned about infants and very young children.”
That’s because pertussis is a highly contagious, potentially deadly disease. At first, its symptoms often mimic a common cold. But left undiagnosed and untreated, the disease can cause severe and debilitating coughing fits–as many as 15 episodes in 24 hours. The nickname “whooping cough” comes from the telltale sound a person makes trying to catch a breath following a fit.
“Whooping cough is often called the 100-day cough because it can last so long,” says Berliner. “It’s a nasty, nasty illness that can be harsh at any age.”
Severe whooping cough fits can cause cracked ribs and broken blood vessels. They can also result in fainting, nausea, vomiting, interruptions with sleep, dehydration, lack of appetite, and other problems.
Unlike COVID-19 and other illnesses caused by viruses, whooping cough is caused by bacterial infection.
The best way to prevent it, Berliner stresses, is to vaccinate. Like many other illnesses, good habits can also reduce the spread. Hand washing, covering your cough, wearing a mask, and staying home when sick all go a long way in reducing the spread of disease.
How does whooping cough illness progress?
The first stage lasts about one to two weeks and often resembles a common cold: a mild cough, a low-grade fever, or a runny nose.
The second stage, extreme coughing fits, generally lasts one to six weeks but can last as long as 10 weeks. In this state, people, especially babies, may have trouble breathing. Fits can be triggered by feeding, crying, and playing. In some cases, babies and young children may not cough or make the characteristic “whooping” sound but may still struggle to breathe.
Why is whooping cough a particular concern with infants?
“There are a few reasons,” says Berliner. “One, their immune systems are not very well developed compared to an older person or an older child, so they have a harder time fighting it off.
Berliner adds that because babies are small, they’re not always strong enough to cough out the thick mucus that develops during illness: “For a very tiny body, that’s very difficult to do. They can struggle to breathe. “
Pneumonia is the most common of the disease’s serious to severe outcomes. But in worse-case scenarios, it can also lead to brain damage, long-term disability, or death, especially for young babies.
Are any areas of King County showing higher rates?
There’s been a higher number of whooping cough cases in South King County according to Public Health — Seattle & King County.
Who should get vaccinated?
“The best recommendation we have is to check your vaccination status now,” says Berliner. “Make sure your family members and the people your family or kids spend time with are vaccinated.” Here’s what up-to-date vaccination looks like:
- Babies and young children should receive the 5-dose DTaP (diphtheria, tetanus, and pertussis) series: The first shot at two months of age and the last between ages 4 and 6.
- At age 11 or 12, a child should receive a Tdap booster with the same ingredients at different levels.
- Adults who received Dtap and Tdap in childhood should receive a tetanus booster, either Tdap or Td, every 10 years.
- If you are an adult who has never received DTap or a Tdap vaccine by age 20, you should get vaccinated.
Get a new Tdap vaccine with every pregnancy
Even though less than half of pregnant people in the U.S. do not get a new Tdap vaccine with each pregnancy, Berliner says that is the best protection for babies: “It is essential.”
Pregnant people should get a new Tdap shot in the third trimester of every pregnancy, no matter when their last vaccine was received. The best time to get the shot is early in the third trimester.
“That is ideal because it gives the pregnant person’s body time to develop antibodies,” says Berliner. “The pregnant person then passes on immunity to the baby in utero. And then when the baby’s born, they have protection in those very vulnerable first two months of life before they can get that first dose of vaccine themselves.”
Berliner notes that none of the birth parents of the three infants hospitalized with whooping cough in the first half of 2024 had received a Tdap in pregnancy.
Berliner says it’s important for anyone likely to be around a baby—including siblings, caregivers, and grandparents—to be up to date on the vaccine.
Is it safe to have another Tdap in pregnancy you had on in your last pregnancy?
“Yes. Get on in every pregnancy. The Advisory Committee on Immunization Practices very, very carefully assesses risk versus benefit,” says Berliner. “And this is one place where they have not equivocated at all—there is always the possibility of side effects or a very rare event as is the case with all medications, but Tdap is considered well tolerated and safe in pregnancy.
Can you still get pertussis if you are vaccinated?
It is possible to contract whooping cough even if you are vaccinated. However, similar to COVID-19 vaccination, having the DTaP or Tdap on board makes severe illness much less likely.
“You’re much less likely to end up in hospital or die,” says Berliner. “And you’re also less likely to spread it to someone else. So vaccination is a win-win.”
What should you do if you think your child was exposed to or has whooping cough?
If your child has been exposed, call your doctor. Your child’s provider may prescribe antibiotics.
Do antibiotics prevent serious illness?
Berliner stresses that early intervention is critical if someone is exposed to or shows early symptoms of whooping cough. “If taken early during the illness, an antibiotic may help prevent an infection from developing, especially in the first two weeks. Once those coughing spells start, antibiotics are not nearly as effective.”
Is 100 cases really that many in a region the size of King County?
“According to the Washington Department of Health, only about one in every 10 cases gets reported,” says Berliner. “Sometimes pertussis gets misdiagnosed; it looks like a lot of other illnesses. At first, it looks like a cold. It looks like COVID. It looks like a light version of many other illnesses until it develops into coughing spells. In milder cases, people may not develop coughing fits and may never see a doctor for care—but they can still be contagious.
” The increase in cases is not unique to King County,” Berliner adds. “This is happening across Washington State and across the country. The best protection is vaccination.”
Read more:
Measles cases found in King County
Hot days ahead: Ways to stay safe in high temps
Should Narcan be in your family medicine cabinet?
