Alabama and North Carolina have joined the list of states battling outbreaks of a Victorian era-disease that has been rocking the US for months.
There are now 123 cases of pertussis, also known as whooping cough, in Alabama and 525 cases in North Carolina.
The illness, which is caused by the bacteria Bordetella pertussis, leads to violent coughing, fever, sore eyes and blue lips. In severe cases, this can lead to vomiting, exhaustion and problems breathing, and is fatal in about one percent of babies who catch the bug.
In the spring, an outbreak began nationally that tapered over the summer, only to pick back up in August – and doctors fear the illness may increase even more heading into cold and flu season, as more viruses weaken immune systems and people are forced indoors with cold weather.
Thus far, 2024 has seen five times the amount of cases as 2023 – with more than 16,000 Americans infected, according to an October update from the CDC. There have been two confirmed deaths.
The most cases have been detected in Pennsylvania, New York, Illinois, California, Washington, Oregon, Massachusetts and Arizona.
Public health officials mainly blame this rise on a lag in vaccination rates since the pandemic.
The CDC recommends children get three vaccinations against the virus, called the Tdap shot, before age one. This shot is 98 percent effective at preventing disease in children within the year following vaccination.
Pertussis spreads from person to person via droplets in the air from coughing or sneezing. Once in the body, the bacteria multiples and releases toxins into the respiratory system that cause tissues to swell, leading to the cough characteristic of the condition
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In Alabama, the cases were detected at high schools in Trussville and Springville, as well as at the University of Alabama Huntsville, in central and northern areas of the state.
Whooping cough cases have increased in the state 300 percent over the past year – increasing from 41 people to 123 people, according to a report from the Alabama Department of Public Health.
In North Carolina, many of the cases were found in Bumbcombe county, which is nestled in the Western part of the state and home to an estimated 275,900 citizens.
In the spring, there were nearly 120 cases in in the state, but that number fell flat over the summer, according to ABC13 News.
Henderson County Department of Public Health spokesperson Andrew Mundhenk said this most recent uptick may be ‘similar to what we saw in the spring.’
As of November 2nd, ABC 11 reported there have been 525 cases of the illness in the state, alongside new outbreaks in measles and pneumonia.
Whooping cough is most commonly spread amongst children and teens, especially when they’re in close daily contact at school or daycare.
Children are particularly vulnerable to the disease because their immune systems are not fully developed – making those under age one at a higher risk of developing severe complications, like breathing problems, from the bacteria.
The highly infectious bacteria gets spread between people when someone sick with the condition coughs or sneezes into the air, and another person inhales or swallows those particles.
Symptoms appear about a week after the initial infection, after the bacteria attaches to tiny hairs in the throat and nose and begin releasing toxins which cause airways to swell, according to the CDC.
Early on, this causes a runny or stuffy nose, low grade fever and a mild cough – but can progress into violent coughing fits that result in vomiting, exhaustion and problems breathing.
‘Those who get these coughing fits say it’s the worst cough of their lives,’ the CDC’s website detailed. About one percent of babies who catch this illness die.
The illness used to kill massive swaths of the population – including thousands of children every year, according to the National Foundation for Infectious Diseases.
Those rates began to taper off following the development of the first whooping cough vaccine in 1948, according to Mayo Clinic.
Currently, the CDC recommends Americans get a series of vaccinations against pertussis over the course of their life. The vaccine developed to fight the illness also contains immunity against tetanus and diphtheria.
The above map shows the state by state rates of vaccination exemptions for the 2022-2023 school year, highlighting the top five states with the highest percentages of exemptions for all mandatory school vaccinations
The first three shots are recommended when a baby turns two, four and six months old. Next, they recommend a shot between 15 and 18 months old, a shot between four and six years old and a shot around 11 years old.
After that, maintenance doses are recommended every decade.
In children, the vaccine is 98 percent effective and in teenagers, the vaccine is 73 percent effective in the year following their immunization.
Though the vaccine doesn’t always prevent someone from getting sick, those who have been vaccinated tend to get less sick than those who have never gotten a vaccine.
However, overall vaccine rates across the country have been plummeting among kids.
The number of people foregoing Tdap vaccinations has been increasing since the early 2000s. In the US, the CDC currently repots that about 80.4 percent of children have been immunized against pertussis by age one.
In Idaho, 12.1 percent of kindergartners entered school with Tdap vaccine exemptions, as did 7.4 percent of Arizonan kindergarteners and 8.1 percent of Utah kindergartners.
Dr Tina Tan, a pediatric infectious disease physician at Northwestern University told NPR: ‘There still is a lot of vaccine hesitancy and anti-vaxxers out there that will not vaccinate their kids.’
If someone catches the disease, a doctor can prescribe a number of different antibiotics.
Sometimes, doctors will prescribe a person these antibiotics just because they’ve been exposed to someone with whooping cough, in an effort to curb the spread.
