None in Methow, but care providers staying vigilant
By Marcy Stamper
Cases of pertussis in Okanogan County continue to climb, with 30 confirmed cases as of Monday (Dec. 31), and medical providers were still awaiting test results, according to Lauri Jones, community health director at Okanogan County Public Health.
There were still no pertussis cases in the Methow Valley, although in the past week and a half, three people had symptoms indicative of pertussis, prompting Family Health Centers in Twisp to test for the highly contagious disease. Two of the tests were negative and the third hadn’t come back from the lab, said Julie Wehmeyer, clinic operations manager, last week.
Jones suspects that the 30 confirmed cases — in Omak, Okanogan, Tonasket and Oroville — underrepresent the incidence of pertussis in the county. For example, the county had one confirmed case in a family of seven and is treating the entire family, she said.
An epidemic of pertussis six years ago seems to have raised people’s awareness of the need for immunization and periodic boosters, which may explain the lower rate of infection in the Methow, said Wehmeyer. The clinic has been working closely with the Methow Valley School District to be sure all children get a booster at age 11 or 12, she said.
Six years ago, there were two dozen pertussis cases in the Methow and more than 4,700 across the state. In 2018, as of Dec. 15, there were 570 cases reported statewide, compared with 719 cases in 2017.
While Family Health Centers hasn’t seen many people with pertussis symptoms — which can resemble a cold or flu, particularly early in the disease — they’ve answered many calls from people who want to be sure they or their children are up-to-date on their immunization, said Wehmeyer.
Confluence Health in Winthrop has treated lots of colds and sniffles and has also been getting calls from people checking on vaccine status, but has had no confirmed cases of pertussis, said Jeanne Walton, the clinic’s practice manager.
Pertussis, also known as whooping cough, starts with symptoms that can seem like a cold or flu, such as a runny nose, sneezing, and a mild cough or fever. But the cough that develops a week or two later is distinctive. “Children with pertussis cough violently and rapidly, over and over, until the air is gone from their lungs and they’re forced to inhale with a loud ‘whooping’ sound,” according to information from the Methow Valley School District.
Medical care providers typically see more flu cases in January and February, and the disease has indeed been ramping up in the past week, said Jones. Family Health Centers in Twisp did 11 flu tests in the last two weeks of December, four of which came back positive.
Confluence Health has had only one confirmed case of flu, in early November, said Walton. Thus far, the flu vaccine seems to be effective, she said.
Wehmeyer stressed the need to be vigilant, particularly since people “see friends and family with lots of different bugs” over the holidays. There are dozens of respiratory viruses with similar symptoms during cold and flu season, said Jones.
While pertussis can be especially serious for infants, the flu can also be deadly, said Jones. Last winter, 185 children in the United States died from the flu (80 percent hadn’t been vaccinated), and more than 30,000 people were hospitalized, the highest number on record, according to the Centers for Disease Control and Prevention.
Jones noted that this is the 100th anniversary of the 1918-19 flu pandemic, which killed 675,000 people in the United States, out of a population of 103 million, according to a report on the epidemic by EpiTRENDS, a monthly bulletin published by the Washington Department of Health.
Globally, the 1918 flu was devastating, killing 50 million people, said Jones. That death toll, at 5 percent of the world’s population, surpassed the deaths in World War I, according to the bulletin.
Moreover, treatment options for flu were limited, since there were no antivirals or antibiotics.
Both pertussis and flu are highly contagious, spreading through droplets from coughing, sneezing, or touching contaminated hands to the mouth, nose or eyes, said Jones.
People under age 2 and over 65, pregnant women, and those with certain chronic medical conditions are at risk of pneumonia or serious respiratory or heart complications from the flu.
The Methow Valley School District sent a letter to all families before the winter vacation, alerting them to the pertussis cases in the county. Fifty students whose vaccines aren’t up to date or who have exemptions on file received a separate letter, said Laura Brumfield, the nurse at the school district.
Children need five doses of the pertussis vaccine by age 5, and a booster at age 11 or 12. Adults need one booster. People who get whooping cough despite being immunized have a much milder disease, with an “aggravating cough, but not the whoop,” said Jones. “It’s more croupy than whoopy,” she said.
The incubation period is typically seven to 10 days, but it can range from five to 21 days. People are most infectious in the first two weeks after they develop the cough, said Jones. Because initial symptoms can be similar to a cold or flu, people often infect others without knowing, she said.
Pertussis is typically treated with a five-day course of antibiotics.