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Disease Known To Hospitalize Children Is Continuing To Spread In Michigan

More than half of infants who contract pertussis, known as whooping cough, require hospitalization.

Once their condition has deteriorated enough to require medical care, there isn't much physicians can do to treat them or speed up recovery. Instead, they offer supportive care, limit spread, and wait for the disease to run its course, said Dr. Francis Darr, a pediatrician in Marquette.

"The key, again, is not so much treatment as it is prevention and avoiding infection in the first place," Darr said.

Michigan is seeing its highest number of pertussis infections in a decade. As of Dec. 8, the state health department reported more than 1,500 cases, which is more than twice as much as the 596-case average from 2017 through 2019.

Public health leaders are urging families to ensure they're up to date on immunizations ahead of the holiday season. Physicians and health leaders held a call with reporters Thursday morning, Dec. 12, to express their concerns and plead for increased vaccination.

"I recently cared for several infants for vaccine-preventable diseases in the Upper Peninsula, including some with pertussis," Darr said. "We have the opportunity to do better with vaccination; to provide better information and partner with parents to improve the health of their children and the health of our communities."

Related: Michigan is seeing more whooping cough, which can be dangerous for kids

Pertussis is also known as whooping cough because of the sound its uncontrollable coughing fits can make for months following an infection.

"It was something where you would wake up in the middle of the night thinking that you would not breathe, and it lasted for months," said Veronica McNally, founder of the Franny Strong Foundation. Her 3-month,old daughter Francesca died of whooping cough in 2012, setting her on a path of advocacy for vaccination against preventable diseases.

The disease can look like a common cold in the early days after infection. Babies and young children may not cough at first and instead have pauses in their breathing that can make their skin look bluish and cause shortness of breath. Within days that can develop into uncontrolled coughing fits.

It can take five to 10 days for symptoms to appear after exposure, health officials said. That paired with the similarity of symptoms to other infections can sometime delay detection.

Bacteria can spread through droplets released by coughing and sneezing. The most susceptible populations are babies, young children, and people with chronic health conditions.

Residents can protect themselves against severe illness from whooping cough by getting the recommended DTaP vaccine. Doses are recommended for babies at 2 months, 4 months, 6 months and 15 months, as well as for pregnant women.

The pertussis vaccine reduces infections by upwards of 80% for children, and reduces chance of severe illness in case of breakthrough infections, according to Ryan Malosh, director of Michigan's Division of Immunizations.

About 83% of Michigan children receive their first dose of DTaP vaccine by the time they're 3 months old, according to the latest state data. However, only 65.5% of 19-month-olds received all four recommended doses.

The U.S. Centers for Disease Control and Prevention (CDC) recommends the DTaP vaccine for adults who didn't receive a dose as an adolescent or adult.

Adults can also get a booster (TDaP) every 10 years to combat waning immunity and help protect vulnerable children in their lives. For more information, visit the CDC's website.

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Respiratory Viruses On The Rise, So Get Vaccinations Updated

Michigan public health leaders are again urging the public to make sure they are up to date on all immunizations to protect against outbreaks of serious communicable diseases such as pertussis or whooping cough, RSV, COVID-19 and the flu.

Michigan is facing a significant increase in pertussis cases, with the highest numbers in more than a decade, according to a news release from the Michigan Department of Health and Human Services. This surge is especially concerning coming amid a busy respiratory virus season, posing risks to vulnerable populations such as infants and unvaccinated individuals.

As of Sunday, the current count of 1,530 cases of pertussis in Michigan is more than 2.5 times the yearly average of 596 cases from 2017 to 2019. More than half of the cases — 826 — occurred in school-age children 5 to 17 years old, and 66% of cases involved individuals who were either unvaccinated or their most recent vaccine was five years ago or longer, according to the Michigan Disease Surveillance System.

Vaccination coverage for pertussis is down 3% from January 2020, with only 73.3% of children ages 19 to 35 months receiving the recommended four doses of diphtheria, tetanus, pertussis — better known as the DTaP vaccine — as of October. School waivers for the DTaP/Tdap vaccine series have nearly doubled over that same period, growing from 3.2% of Michigan kindergarten students with a waiver in 2020 to 6.2% in 2023, according to the news release.

"As Michigan faces a record number of pertussis cases, it's more important than ever for parents, caregivers and communities to prioritize vaccination," said Ryan Malosh, director of the MDHHS Division of Immunization. "Whooping cough is a serious, preventable disease that can have devastating effects, especially on babies who are too young to be fully vaccinated. By staying up to date on immunizations, including booster shots for teens and adults, we can protect our loved ones and prevent the spread of this highly contagious disease. Immunization is not just an individual responsibility — it's a critical step in safeguarding public health."

Pertussis often starts with mild cold-like symptoms but progresses to severe coughing fits that can last for weeks or months. Commonly called whooping cough, pertussis is known for the "whoop" noise when someone gasps for air after a coughing fit. It can take five to 10 days for symptoms to appear after exposure and sometimes longer. Babies and young children may not cough, but they may have pauses in their breathing — called apnea — that can make their skin look bluish or cause shortness of breath. Later symptoms can include uncontrolled coughing fits.

Pertussis is most dangerous for infants under 1 year of age, as they are at higher risk for severe complications such as pneumonia, brain damage and even death. More than half of infants who contract pertussis require hospitalization.

The CDC recommends the pertussis vaccine for infants, children, adolescents and people who are pregnant. It also recommends a dose for adults who haven't received a dose as adolescents or adults.

The CDC and the Advisory Committee on Immunization Practices also recommend the COVID-19 vaccine and an annual flu vaccine for everyone 6 months of age and older as part of the recommended childhood and adolescent vaccination schedules.

Illinois Ranks Fourth For Whooping Cough Cases Nationwide

Whooping cough cases remained high this year in Illinois, a trend likely driven by low vaccination rates and waning vaccine immunity, but also by better detection through more and improved testing.

As of the end of November, 1,902 whooping cough infections were reported in Illinois this year, according to the Centers for Disease Control and Prevention.

That's three times more cases compared to the same time last year and the highest number of cases the state has seen since 2012, according to the Illinois Department of Public Health. Cases in Chicago have also reached a 12-year high at 265 reported cases, the Chicago Department of Public Health reported.

"Increasingly, since the COVID-19 pandemic, we are seeing many of these infectious diseases have high numbers after dropping during the pandemic, including whooping cough," Sameer Vohra, the director of the state's health department, told the Sun-Times.

Before the pandemic, spikes in whooping cough cases would happen every three to five years, according to the city health department.

Whooping cough, also called pertussis, is a highly contagious respiratory disease. The telltale symptom of the infection is a cough that lingers and gets worse over several weeks. The infection is most severe in infants. One in three babies under a year old with whooping cough are hospitalized.

In October, 408 whooping cough cases were recorded in Illinois, the largest monthly total in 20 years, according to the state health department.

Illinois has the fourth highest amount of cases in the country, according to the CDC's figures. Pennsylvania, Wisconsin and New York have reported more infections this year.

Larry Kociolek, an infectious disease doctor at Lurie Children's Hospital, has noticed an increase in cases this year. A low vaccination rate is partly to blame, he said. People got behind on their vaccinations during the pandemic and still haven't caught up. The effectiveness of the pertussis vaccine also wanes over time.

"The most significant impact of the pandemic on whooping cough would be declining vaccination rates leaving people more vulnerable and more exposed," Kociolek said.

The DTaP vaccine for kids is five doses given throughout the first six years of a child's life, which requires regular primary care visits.

"There are several doses given during childhood. The vaccine gets more effective over time," Kociolek said. "But immunity wanes when entering adolescence, so that's why we give a booster and then again in early adulthood."

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Illinois is still not back up to routine immunization rates compared to before the pandemic, Vohra said. For kindergartners, the state vaccination rate is 91.7%, slightly lower than the national rate of 93.1%.

"One of our continued messages is how important these routine vaccines are and how they can make a really big difference for preventing severe disease," Vohra said.

Another explanation is doctors are testing for whooping cough more, so they're identifying more cases, Kociolek said.

"Pertussis is easier to diagnose now than a decade ago," Kociolek said. "Rapid and highly accurate tests are now more available, making it easier to recognize cases."

The most effective way to prevent whooping cough is for both kids and adults to be vaccinated, Kociolek said. It's recommended adults get the Tdap vaccine booster every 10 years, which protects against tetanus, diphtheria and pertussis.

Vaccinations are especially important for pregnant people and anyone caring for infants and young children, he added.

For both kids and adults with whooping cough, Kociolek recommends seeking medical help if the cough gets more severe and the person is struggling to breathe or throwing up because of the cough.

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