Fargo Cass Public Health (FCPH) is stressing the importance of getting vaccinated for pertussis as cases continue to be identified in Cass County. Since January 2024, there have been 41 reported cases of pertussis in Cass County. At least 15 cases have been reported since August 1st, a number that is expected to increase. Cass County typically reports five to eight cases in an average year. Pertussis, also known as whooping cough, is a highly contagious respiratory illness that spreads easily from person to person through the air. People with pertussis usually spread the disease by coughing or sneezing while in close contact with others, who then breathe in the pertussis bacteria. Pertussis is one of the most commonly occurring vaccine-preventable diseases in the United States.
Dr. Tracie Newman, Health Officer for FCPH says, “As we head back into schools and childcare settings, now is more important than ever to make sure you and your family are up to date on all vaccines, including key ones for this respiratory season: COVID, flu and RSV. Being up to date ensures not only your safety and wellbeing but also minimizes disruptions in your daily life and within the community."
Vaccination is the best available safeguard against pertussis, providing protection not only for the person vaccinated but for others around them as well. Available pertussis vaccines are highly effective, but a person’s immunity can wane over time. Studies show that when vaccinated, people who get pertussis cough for fewer days, experience less whooping, coughing fits, or vomiting after coughing and apnea is less common in babies. Vaccination during pregnancy also protects the baby during the first months of life when they are at the highest risk. A highly vaccinated community is able to protect those who are too young to be vaccinated.
Recommended vaccines:
• DTaP (Diphtheria Tetanus and acellular Pertussis) vaccine
- Routinely given at 2, 4, 6, and 15 - 18 months; booster given at 4 - 6 years old
- Catch-up immunizations for children less than 7 years old
• Tdap (Tetanus diphtheria and acellular pertussis) vaccine - Routinely given to adolescents 11 - 12 years old
- Catch-up immunizations for children older than 7 years old
- Recommended booster every 10 years in adults (preferred to Td booster)
- Special populations: 3rd trimester of every pregnancy (27 - 32 weeks gestation), infant close contacts (parents, grandparents, child-care providers, etc.) and health care workers
Recommended actions and information for community members:
Individuals experiencing a prolonged cough or other ongoing symptoms should be seen by a medical provider to inquire about testing and/or treatment. Individuals who have been exposed to pertussis may need preventive antibiotics. This is especially important if there is a baby or pregnant person in the household or if the exposed individual plans to have contact with an infant or pregnant person.
Hygiene recommendations:
• Frequent hand washing – wash with soap and water for at least 20 seconds or use alcohol-based hand sanitizer.
• Cover your cough or sneeze.
• Stay home when sick.
Recommended actions and information for providers:
Providers are encouraged to suspect and test for pertussis in patients presenting with a prolonged cough, especially if patients are negative for influenza, COVID-19 and/or RSV. Pertussis can have an insidious onset with symptoms indistinguishable from those of typical seasonal respiratory tract infections. Symptoms usually develop 5 – 10 days after exposure (can be up to 21 days).
Pertussis clinical criteria:
• Cough for 2 weeks or more and at least one of the following:
- Paroxysms of cough
- Inspiratory whoop
- Post-tussive emesis
- Apnea (infants)
Unvaccinated and/or under-vaccinated people, especially infants less than 12 months old are at the highest risk for increased morbidity and mortality from pertussis. In infants, apnea may be the only symptom as cough can be minimal or absent. If pertussis is suspected, it is recommended to treat and exclude patients from work, school and/or childcare for five days after the start of antibiotics or 21 days from the onset of cough. It is not necessary to await lab results to initiate treatment.
All household contacts of confirmed cases, with or without symptoms, should receive appropriate antibiotics. Centers for Disease Control and Prevention also recommends preventive antibiotics for those at increased risk for severe disease (infants, pregnancy, immunocompromised) or those who will have close contact with someone at increased risk for severe disease.
Pertussis is a reportable condition to North Dakota Health & Human Services Department, which will conduct contact tracing as needed. For more information about pertussis, visit, HealthyChildren.org.