The number of whooping cough cases in McLennan County has more than doubled in two weeks, forcing the public health district to launch an investigation into what it is calling a “communitywide outbreak.”
The Waco-McLennan County Public Health District is now investigating eight cases of whooping cough, or pertussis, up from three cases that were reported two weeks ago, according to health district spokeswoman Kelly Craine.
The three original cases involved people known to each other, but the additional five cases do not include a common source, Craine said.
Whooping cough is an extremely contagious respiratory illness caused by a type of bacteria that attach to the tiny, hair-like extensions that line part of the upper respiratory system, according to the Centers for Disease Control and Prevention. The bacteria release toxins that damage the extensions and cause the airways to swell.
Two of the original pertussis cases involved children who attended Sunday school classes at Antioch Community Church, one of Waco’s largest congregations with an average Sunday service attendance of 3,500, Executive Pastor Jeff Abshire said. That number includes about 900 children.
Abshire said he does not know if any of the new cases are related to the Antioch ones. The church shut down two of its children’s Sunday school classes for three weeks, which is the incubation period for pertussis. The church still plans to reopen its youth Sunday school classes this weekend but will continue to monitor the situation, he said.
Vaidehi Shah, senior epidemiologist at the health district, also said it is unclear if the new cases are associated with the two Antioch cases. Most of the eight cases involve children.
“There may be a common source that we probably don’t know right now, and it could be that there are multiple common sources,” Shah said. “We’re trying our best to find a common source, but that’s why we mention it’s a communitywide outbreak because we have multiple places that may have been the source.”
She said it is so difficult to pinpoint the source of the contagion because of the long incubation period for pertussis. It is one of roughly 80 conditions health care providers in Texas must report to the state or local health department.
“The incubation period, which is from the date they were exposed to when they get symptoms, is three weeks,” she said. “That’s a long incubation period to find out exactly what time or what location they got sick from.”
Shah said whooping cough spreads through respiratory secretions and that it is so highly contagious that just coming into contact with an infected person’s respiratory secretions can lead to infection. That is why she emphasized vaccinations for people of all ages, even adults. Adults around newborns should get their booster immunization to protect the child because infants cannot receive their first pertussis vaccination until 2 months old.
Infants and children should get five doses of the diphtheria, tetanus and pertussis immunization for maximum protection, according to the CDC. Babies receive the vaccine at 2, 4 and 6 months of age and again at 15 to 18 months. Children also receive the vaccine from age 4 to 6, and a booster should be given to preteens at 11 or 12 years old.
“We want to protect the children, but adults are just as vulnerable,” Craine said.
Dr. Jacquelin Dewbre, a pediatrician at Baylor Scott & White’s Hillcrest Pediatrics Clinic, said infants do not have full immunity to pertussis until they receive the 15-month immunization. She recommended parents with newborns stay out of public spaces until the outbreak ends.
“Whooping cough in babies can be deadly. They just stop breathing. They cough so hard they can’t breathe,” Dewbre said. “It’s not as deadly in adults as it is in babies.”
She said about 1% of infants younger than two months die from the disease but that it does happen. Younger children and older adults are most vulnerable to the disease.
Dewbre said anyone with a prolonged cough should visit a doctor to ensure they do not have whooping cough. The cough may not have the telltale “whooping” sound but could still be pertussis.
Treatment for pertussis generally includes antibiotics. The best form of prevention is vaccines, according to the CDC, but vaccine protection erodes over time. The CDC recommends pertussis vaccines for people of all ages.