Buncombe's Pertussis Numbers Alarm Health Agencies - TribPapers
Health

Buncombe’s Pertussis Numbers Alarm Health Agencies

Records show a strong correlation between vaccinations and the decreasing incidence of pertussis. Source: CDC.

Asheville – On Thanksgiving Eve, as families were in the process of gathering to enjoy their traditional concurrent days off work and the less fortunate were being encouraged to go to congregate shelters for a Code Purple, news began circulating that the Buncombe County health department had issued a public health alert. There was a “multi-school outbreak” of whooping cough, otherwise known as Bordetella pertussis or the 100-day cough. The preponderance of cases are afflicting school-age children from “areas all around the county.”

A week ago, the county did issue an alert after 18 cases had been confirmed. Only six cases were confirmed the month prior. The news reports dated November 27 claimed 45 cases had been confirmed. This could not be confirmed by press time, as government offices, including those at the health department and CDC, were closed. The CDC wouldn’t have had anything to report, as its data lags about a week, but nothing was showing up on the county’s website or social media accounts, either. What matters is that 18 cases are enough to justify precautions.

Bordetella pertussis spreads when an infected person coughs or sneezes, releasing it into the air to be inhaled by another person. When it gets in the lungs, it elicits an inflammatory response that makes it harder to breathe. The result is a cough that can expel so much air that the afflicted person has to gasp, or whoop, to refill their lungs. What’s tricky is that in its early stages, whooping cough is difficult to distinguish from the common cold, yet very contagious.

The initial, “common cold” symptoms show up anywhere from 5 to 20 days after exposure. After a week or two and on into the next months or years, symptoms could include secondary effects from thick mucus buildup in the lungs. In addition to trouble breathing, these could include vomiting, a red or blue face, extreme fatigue, and problems sleeping. Complications from the persistent, strenuous coughing have been as violent as bruised or cracked ribs, abdominal hernias, and ruptured blood vessels in the skin or eyes. Yet, some people can have whooping cough without even making the whooping noise.

Babies and infants who have not yet completed their five-shot vaccination course, as well as teens whose vaccinations are wearing off, are usually the most susceptible to catching it. Babies’ lungs are often not developed enough to cough as hard as the infection demands. They instead may suffer life-threatening conditions like apnea, pneumonia, dehydration, weight loss, seizures, or brain damage. An estimated one-third of babies that catch pertussis end up in the hospital; 1% succumb.

Adults with only mild cases are carriers capable of transmitting severe cases to infants, teens, and immunocompromised individuals. Public health agencies therefore stress the need for vulnerable populations, as well as women carrying babies and people planning to be around newborns, to be vaccinated, and they recommend that adults get booster shots every ten years.

“To protect infants, the most vulnerable members of our community, we encourage everyone to be vigilant in containing the spread of this bacterium,” read a release from the county. “For people who develop symptoms of whooping cough, it is essential to seek medical attention for testing and treatment as soon as possible to reduce the length and severity of illness.”

Vaccines work best prophylactically. Once the disease is contracted, the afflicted person may benefit from prescription antibiotics, but the CDC and other groups that establish guidelines are shying away from this practice, citing concerns about overprescription-induced resistance. So, the county is encouraging all persons to schedule a vaccination appointment by calling their primary care providers or the health department at 828-250-5000.

Statewide, 576 confirmed cases were reported year-to-date by November 23. That’s a 640% increase year-over-year. Nationally, the number of confirmed cases quintupled. Actual counts are expected to be about ten times higher because not everybody who gets whooping cough seeks professional attention. Epidemiologists continue to see higher case numbers in populations less inclined to access vaccinations. They are also attributing the increasing number of cases among adolescents to “vaccine hesitancy” or “vaccine fatigue,” spurred largely by the politicization of the COVID vaccines, at all levels of the response.

Health officials stress that, while no vaccine is 100% effective, this one is highly effective and, in the instances that it does not prevent the infection, it should mitigate symptoms. Historically, the number of annual cases in the country fluctuated around 200,000 until sharply descending in the 1940s, when the first vaccines came out.