Whooping cough is spreading again in Oregon, with 178 cases reported so far across nine counties.
It’s a common bacterial illness that is mild in most people who have been vaccinated.
Pregnant women and families with infants too young to have been fully vaccinated should take particular precautions, though: It can be serious and even fatal for infants younger than 6 months.
To date, 16 infant cases have been reported in the state.
FILE: A 10-year-old Milwaukie resident shows off her bandage after receiving a vaccination in Happy Valley, Ore., in 2021.
Kristyna Wentz-Graff / OPB
Oregon reported record low cases of whooping cough during the height of the COVID-19 pandemic, as masking and other measures reduced transmission of the bacteria that causes it, Bordetella pertussis. Lower disease transmission has led to waning immunity across the population.
“Many more people were susceptible, and the cases started exploding this past month,” said Dr. Paul Cieslak, Oregon’s director for communicable diseases. It’s too soon, he said, to know if this year’s outbreak will be larger than a normal year.
Lane County has reported the most cases to date, 64, followed by Multnomah (41), Clackamas (33), Deschutes (15), Washington (13) and Jefferson (8) counties. Most of the reported cases are in children. The actual number of cases is likely far higher, as many with whooping cough have milder symptoms and don’t see a doctor.
Antibiotics are effective against pertussis, but there’s a catch: They only work when they’re given early in the course of the illness. But the early symptoms of whooping cough — sneezing, runny nose, sore throat — make it hard to differentiate from allergies or common viruses.
More unique symptoms include coughing with a “whoop” sound, fits of coughing, particularly at night, and coughing so hard a person vomits.
“By the time you’re feeling badly enough to go to the doctor and get a test, it’s often too late to treat,” Cieslak said. “Trying to treat everybody who had pertussis with antibiotics was really futile.”
In 2006, the public health strategy against pertussis changed dramatically from a “search and destroy” approach that focused on stopping as many cases as possible to a targeted approach that focuses on protecting infants.
Cieslak said most households that suspect they have pertussis do not need to seek out antibiotics unless they have a baby at home.
“If a case gets reported to public health, our first question is, do you live in a household with an infant? If the answer is yes, then antibiotics for everybody.”
Households that don’t have an infant can check with their doctors to see if antibiotics are appropriate.
Getting vaccinated is the other key way to protect everyone, including the youngest Oregonians.
Children typically receive a vaccine, which includes protection against pertussis, every two months until 6 months old, again as a toddler, and finally around age 4 or 5.
And pregnant people can protect babies under 2 months old by getting a vaccine between 27 and 36 weeks of gestation. Antibodies the mother makes then pass across the placenta and provide protection to the baby in its first weeks of life.
The vaccine is safe with minimal side effects — the most common is a sore arm. Ceislak said the only known serious side effect is when someone is allergic to one of the vaccine components, which is rare. Millions of pregnant people have received it since the CDC began recommending it in 2012.
Among 16 infant cases reported in Oregon to date in 2024, only one mother had a documented dose of the vaccine during the pregnancy.
In Oregon last year, 8.8% of kindergarteners were not up to date on all their vaccinations, and didn’t have a medical exemption.
That puts Oregon near the bottom of the 50 states when it comes to protecting children from preventable illnesses.
