United States: Along with other respiratory illnesses, whooping cough has also been emerging as a concern across the United States. Amid the heightened worries and concerns, Oregon health authorities issue a stark caution regarding a notable surge in pertussis instances across the region — urging Oregonians to avail themselves of vaccination amidst a staggering 770% spike in reported cases, as revealed by the Local Health Authority on Thursday.
As of May 29, 178 pertussis cases have been documented to the OHA in 2024, in contrast to a mere 20 cases at that juncture in 2023, according to the reports by koin.com.
The alerts concerning pertussis — also known as whooping cough — arrive amidst a mounting number of Oregonian juveniles lagging in immunization, according to the Oregon Health Authority.
“Our apprehension lies in the swift escalation to such a significant number of pertussis incidents, indicating the disease’s adeptness at rapid dissemination and exacting a heavier toll on those inadequately vaccinated,” articulated Dr. Paul Cieslak, the medical overseer for communicable diseases and immunizations at the public health division of the Oregon Health Authority.
Amongst the nine counties thus far reporting cases, Lane County leads with 64 instances, trailed by Multnomah County (41), Clackamas County (33), Deschutes County (15), Washington County (13), and Jefferson County (8).
School-aged children and adolescents account for 92 (52%) of the cases, with 51 (55%) of this demographic up to date with their pertussis inoculations, as per OHA data.
Health officials highlighted several factors contributing to the surge in cases.
“Partially, at least, the cessation of the COVID era where stringent restrictions were in place; ubiquitous masking, business closures, and prohibition of large congregations,” elucidated Cieslak. “We experienced a hiatus, an exceedingly low ebb in pertussis incidents, unprecedented during that period, and now witnessing a resurgence to conventional levels.”
Despite the considerable uptick in cases, OHA indicates that the tally thus far in 2024 is roughly commensurate with those seen during analogous periods in the pre-pandemic years, with 93 cases recorded in 2019 and 248 in 2018, as reported by koin.com.
“Preceding COVID, we experienced peaks in disease incidence every three to five years, with case numbers soaring. In 2012, for instance, we encountered 910 cases for the year, marking a particularly dire period. It remains premature to ascertain whether this year will mirror the severity of 2012, but we are currently observing a substantial caseload,” Cieslak remarked.
Infants face the highest susceptibility to pertussis-related complications and mortality, exhibiting the highest incidence rate, OHA emphasized. Between 2003 and 2023, infants constituted 12% of cases and 76% of pertussis-related hospitalizations.
Pertussis fatalities in Oregon have been confined to infants, with five fatalities recorded since 2003, according to OHA statistics.
The state health agency advocates for universal vaccination, underscoring that expectant individuals can receive the Tdap vaccination, affording protection against tetanus, diphtheria, and pertussis. Individuals aged 10 years and above are likewise encouraged to undergo a singular Tdap dose, according to koin.com.
“Those most vulnerable to hospitalization due to [pertussis] are infants, particularly those too young to receive vaccination, thus warranting our dissemination of the uptick in cases, as such occurrences can be preempted if pregnant individuals undergo vaccination between 27 to 36 weeks of gestation. This facilitates antibody production, subsequently passed through the placenta to shield the newborn from birth,” elucidated Cieslak.
Amongst the 16 infant cases reported in Oregon thus far in 2024, one maternal figure had undergone documented Tdap vaccination during pregnancy, according to OHA.
“Ordinarily, vaccination for infants occurs at two, four, and six months, followed by a subsequent dose in toddlerhood at 15 to 18 months, and yet another dose prior to preschool. However, it is those infants under six months of age, yet to complete the full vaccination regimen, who face heightened risk,” elaborated Cieslak, according to the reports.
For adults, pertussis symptoms may encompass prolonged coughing or fits thereof, surpassing the duration typical of a common cold, yet for infants, the infection bears potentially life-threatening consequences, according to Cieslak.
Amidst the steep surge in pertussis cases, Oregon has also witnessed a rise in the number of children trailing in vaccinations, as per OHA observations.
“Despite CDC directives emphasizing the prioritization of early childhood well-child visits amid the COVID-19 pandemic, a downward trend in the up-to-date rates of childhood immunizations since the 2020 peak highlights a growing proportion of children lagging in their immunization schedules,” OHA iterated.
This encompasses a series of vaccinations against 14 potentially severe ailments, including diphtheria, pertussis, tetanus, polio, measles, mumps, rubella, and hepatitis B.
In 2018, 68.8% of Oregonian children were current on vaccinations, a figure that climbed to 71.2% in 2019, reaching a pinnacle of 71.3% in 2020 before receding to 68.3% in 2023.
Within the recommended early childhood vaccination series, OHA noted that PCV — conferring protection against pneumococcal disease — registered the lowest up-to-date rate, thereby influencing the overall series completion rate.
Officials postulated that this could be attributed to the requisite four doses for the PCV vaccination regimen and its non-mandatory status for school attendance, as per koin.com.
OHA underscored that certain individuals may encounter obstacles in accessing vaccinations, be it difficulty securing appointments at local clinics or lack of insurance coverage. Others may defer or eschew vaccination due to religious or personal convictions.
With 68% of children vaccinated in 2023, OHA expressed its aspiration for universal vaccination amongst children — highlighting instances where certain states have achieved vaccination rates surpassing 95%.